Similar medications to propranolol LA

[Volcom23]

Hi, just wondering if there are medications similar to Inderal LA?

[Svojski85]

Hi, I would also be interested in this as AstraZeneca (producer of Inderal LA) have discontinued Inderal LA. I've been on Inderal for 2 years, it changed my life for the better, I managed to become a law student at a university from a homeless man (it sounds incredible but it is true indeed; in between 4 years 2009-2013), and I'm sure you know what is Inderal all about without me telling you... But if you don't mind, then I will tell you my bit.

Check Wikipedia and you will see some general information. E.g. propranolol was first synthesized in 1964 by J.W. Black et al. who then received a Nobel price in Medicine for their achievement (1988). Then, the first patent holder was AstraZeneca; the mighty British pharmaceutical firm which was recently subject to an offer by their largest US competitor Pfizer. Again, money played a large (and the only) role in the decision-making of AstraZeneca whether to keep Inderal on the market or withdraw it.

Since January 2014, Inderal has stopped being produced and only the leftover stock was being sold by some pharmacies. Now, in May 2014, it seems here in North Yorkshire that you can't really get it anywhere. For 20-some years AstraZeneca held onto the patent and put all their pride into the actual production and preparation of the product so that a best preparation (i.e. medicament quality) would build up the reputation of the AstraZeneca brand. It makes sense to make your product work as best as you possibly can if you have a monopoly (patent) for one highly-sought after medicine which even the WHO put on their list of quit-essential medicines which each country in the world should have in their main stock. However, after the patent expired, there were other pharmaceutical companies on the market and indeed, they were hungry, very hungry, for their share on the profits from the sales of this drug. What did they decide to do?

Well, Sandoz (producer of Bedranol SR capsules; apparently "equivalent" to Inderal LA) started using the cheapest pill excipients (i.e. the binding and coating material). Where AstraZeneca was using the very expensive hypromellose, microcrystalline cellulose and ethyl cellulose (all very expensive to make pill coatings and fillers which dramatically improve quality and effect and duration of the pill), Sandoz used simple naturally-occurring starch and sugar! How simple yet powerful!

I had to abandon Inderal LA a month ago and I can say with 100% certainty that Bedranol SR is far far far from being equivalent to Inderal LA, although according to law and regulations by MHRA (Medicines and Healthcare Products Regulator Authority) the maximum difference in the effect of the generic medicament (i.e. medicament for which a patent has expired) should be no more than 10% I think. Where Inderal LA lasted between 10-20 hours in your bloodstream, Bedranol SR is there for 3-6 hours, according to my dreadful personal experience.

I would be keen to learn from other Bedranol SR users how they found their switch from the former Inderal to the new drug. I would definitely be interested in the experience of others who take the pills instead of the Bedranol SR or Inderal capsules. I discussed this issue with my GP, he prescribed me some film-coated pills (film-coated tablets also avaiable; produced by Actavis and Accord Healthcare) to compensate for the dips in the quickly dissipating effect of Bedranol SR, and it is OK but too messy. If I could divide the seas, I would order that production of Inderal was reinstated .

All medications, as well as propranolol-based medications, can be found by searching the medicines.org.uk website search field.

[Catherine S]

I read something similar when another member questioned generic meds and if they existed. I take something called Propranolol-CT and are film-coated and my pharmacist has to order them as he doesn't stock them on a regular basis. He told me that alot of doctors have stopped perscribing them as, being one of the first of its kind they prefer the modern equivelants. Don't know how true that is though. They have always suited me and been fit for purpose. It makes me a bit nervous to think they may be abandoned soon and then have to find another of its kind that suit my system as well.

ISB x

But why didn't AstraZenica still produce them even after the patent ran out? Couldn't they have carried on as well as all the other companies who now produce them? Or isn't that allowed under the terms of a patent...which I don't know much about how it works sorry.

[Svojski85]

I read something similar when another member questioned generic meds and if they existed. I take something called Propranolol-CT and are film-coated and my pharmacist has to order them as he doesn't stock them on a regular basis. He told me that a lot of doctors have stopped prescribing them as, being one of the first of its kind they prefer the modern equivalents. Don't know how true that is though. They have always suited me and been fit for purpose. It makes me a bit nervous to think they may be abandoned soon and then have to find another of its kind that suit my system as well.

ISB x

But why didn't AstraZenica still produce them even after the patent ran out? Couldn't they have carried on as well as all the other companies who now produce them? Or isn't that allowed under the terms of a patent...which I don't know much about how it works sorry.

Hey Believer. I think that the reason why AstraZeneca stopped producing the INDERAL LA after their exclusive license had expired can only be financial reasons. The main reason must logically be low overall revenue (e.g. demand is generally low; drug is not being prescribed that much; it is only the second-choice medication and something else is being prescribed by the GPs), low profit (e.g. it is not economic enough to incur high production costs for a tiny profit) or simply a combination of both these reasons.

One reason (I'd say) behind the low revenue could be aggressive marketing of the relatively new players on the market (Sandoz) who simply want "their share" after x-many years of monopoly of AstraZeneca (due to patent). There are many ways how a drug is marketed. It could be marketed within the surgeries, within hospitals as well as with the dispensing pharmacies. They all are one large family of doctors who are regularly meeting at various events, conferences and sponsored get-togethers.

Second reason could be some dealings behind the curtains by the directors of these pharmaceutical companies. Something along these lines: 'I drop production of this drug for your benefit and high share on this drug market, but you drop your other drug for me to get a high share on some other drug market. In the end, we avoid harmful competition to ourselves, simplify our operations and save ourselves the production costs.' This is hypothetical but you might not want to exclude such deals, really.

Third reason (I think) might be the relatively expensive production of INDERAL LA for a tiny profit compared to the relatively cheap production of BEDRANOL SR for a much bigger profit (as I explained above, BEDRANOL uses only cheap ingredients, i.e. sugar and starch). There is no point for a company seeking profit to produce something which can be (and is being) made in a much cheaper way, especially on the corrupt basis that doctors (as well as pharmacists) are being mislead by the very odd achievement of Sandoz (BEDRANOL SR producer) to register their drug with HMRA as 'bioequivalent', i.e. claiming in their official lay report to have the same effectiveness, allegedly present in the bloodstream for 10-20 hours which is however a scientific nonsense for BEDRANOL SR does not have the same (or even close to same) ingredients/excipients as INDERAL LA. Achieving equivalent effectiveness of BEDRANOL SR with cheap excipients is just a huge nonsense because if it were true, then every other pharmaceutical company would be doing this. In connection to propranolol, only Sandoz relies on sugar and starch in the preparation of their propranolol. All other producers use a chemical called hypromellose which protects the pill from rapid dissolution in your tummy and which is highly desirable (if not essential) in pills intended to have a sustained (whole-day) release.

I also checked some licensed on-line UK pharmacies and there is literally a penny difference in the retail market price between one pack of INDERAL LA and BEDRANOL SR. So, it seems that even if AstraZeneca wanted to increase the price of their product (to get a healthier profit then they were getting), they probably would not be allowed to for I believe that the price of one drug is set at the very beginning of its registration and can't be changed afterwards. Therefore, AstraZeneca was trapped in the years after their patent expired, Sandoz undermined their position by falsely claiming that BEDRANOL SR had a bioequivalent characteristic, and although AstraZeneca made an effort to keep their better quality product on the market for some time, to allow the consumer patients to make their better choices, it was a waste of time for AstraZeneca for in the end, Sandoz managed to market their inferior product so well that they effectively pushed INDERAL LA to the demand edge, regardless. AstraZeneca did not have in the end any desire or motivation to keep producing and selling their product.

So, you see that there are multiple possible reasons why one profit-seeking company would stop producing one rather helpful drug. It is all about the money, not us .

[Catherine S]

Its scandalous really isn't it? I mean the drugs are produced initially to help people but go by the wayside in time and becomes about the producers

But thank you for sharing the information, very interesting.

[Svojski85]

Its scandalous really isn't it? I mean the drugs are produced initially to help people but go by the wayside in time and becomes about the producers

But thank you for sharing the information, very interesting.

It is scandallous, I suppose, for I can't see that some medicaments are "somehow" bioequivalent (the buzz word here) and get the stamp of approval by MHRA. I can testify in any court that simply after 4 weeks on BEDRANOL SR (which is supposed to be bioequivalent, i.e. similar) to INDERAL LA, it was not the case at all.... I felt dizzy in the morning, had constant panic attacks throughout the day, was sweating a lot, withdrew socially, was anxious all the time, had neurotic thoughts about my previous life experiences, and was generally grumpy and had animated temperament, got easily offended and was quite sensitive generally and on overall. Does this sound as equivalent to INDERAL LA, where I never experienced any of these for good 2 years prior?

I contacted MHRA with this, reported side effects, and also got in touch with the inspectorate so they had perhaps a second look at what they approved for the patients. I was never diagnosed (I would rather not be, just for the reason not to fall into the incorrect bracket and so on) but INDERAL LA changed my life for the better, and I turned my bad life around slowly. I was relatively a happy person as I was doing what I wanted. With INDERAL LA going out of the market, and with these seemingly equivalent drugs, I think people should do something about it and report it to MHRA if they feel affected.

I quite unfortunately do, but let's hope things would improve.... After 4 weeks on BEDRANOL SR, which did not work for me at all, I'm now on BETA PROGRANE (contains at least the ethyl cellulose coating), and it feels better. It is not the same as INDERAL LA though as I still get concerning thoughts on my mind ever so often about different small things, but it is slightly better...

[Svojski85]

UPDATE: Just a quick update on the equivalence controversy... Except for BEDRANOL SR (who claim something they simply can't achieve on inferior cooking ingredient, e.g. peak in 1 hour), there are also honest alternatives on the market as I pointed out earlier. These alternatives do not kick in your system that quick, it can take them 5 dreadful hours to kick in, which most anxiety patients can find very intimidating, but this can be supplemented by taking a short-acting (i.e. quick-acting) propranolol pill in the morning. Basically, you just need to top up in the morning, otherwise the rest of the day should be managed by the otherwise equivalent drugs.

[Pipkin]

I used to take oxprenolol until the standard form was discontinued so I moved to propranolol. They still make the extended release type and it's very similar to propranolol. In fact, I found it better. I believe the brand is called Trasicor or slow-trasicor.

Pip

[Svojski85]

Hi Pipkin, how kind it is of you to suggest some alternatives. I find it much better to others who just don't give a shit. I checked with MHRA on the properties of this drug and unfortunately, there is not any 24-hour formulation there, although oxprenolol might be similar in the effect in comparison to propranolol since they are both the same beta-receptor antagonists, although oxprenolol (even the slow trasicor) is supposed to work between 1-2 hours only.

When you said that you found oxprenolol better, then I would attribute it to the fact that oxprenolol gets absorbed somewhere between 20-70% upon its first blood circulation passover across the liver, whereby propranolol gets absorbed in any circumstance by always less than 20%. So it could have been better for there was more of the beneficial drug in your system on overall since the liver did not flush it all away from your body, but kept the most of it in there.

I am now in my 3rd month on inferior propranolol and I can't concentrate, sleep at night and I am getting flashbacks too often... God please help me.