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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR INDERAL


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All Clinical Trials for INDERAL

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00060866 ↗ Propranolol to Treat Fainting Due to Sympathoadrenal Imbalance Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 4 2003-05-01 This study will examine the effectiveness of the drug propranolol in preventing fainting in patients with sympathoadrenal imbalance (SAI). SAI is a particular pattern of nervous system and chemical responses in which the blood vessels in skeletal muscles do not remain constricted appropriately during standing for a long time. This can lower blood pressure and cause fainting. Propranolol Inderal (registered trademark) is a Food and Drug Administration-approved drug that belongs to a class of drugs called beta-blockers. These drugs slow the heart rate and maintain blood pressure in certain situations. Patients 18 years of age and older with SAI may be eligible for this study. Screening includes a tilt table test, described below, to determine if the patient has a particular chemical pattern in the blood. Patients enrolled in the study take propranolol pills in increasing doses during the first week of the study to determine the proper dose for the individual. Then, the drug is stopped until the experimental phase of the study begins. In this phase, patients are randomly assigned to take either propranolol or placebo (look-alike pill with no active ingredient) for 4 days. On the fourth day, the patient undergoes a tilt table test to determine whether the treatment affects the patient's ability to tolerate tilt. For this test, the patient lies on a padded table with a motorized tilt mechanism that can move the patient from a flat position to an upright position in about 10 seconds. The patient remains upright for up to 45 minutes while the following measurements are taken: - Arterial blood pressure monitoring and arterial blood sampling. A catheter (thin, plastic tube) is inserted into an artery in the elbow crease area of the arm or the wrist. This catheter allows continuous blood pressure monitoring and sampling of arterial (oxygenated) blood during the tilt test. - Venous blood sampling and measurement of epinephrine and norepinephrine release. A catheter is inserted into a vein in each arm, one to collect venous (deoxygenated) blood samples, and the other to inject radioactive epinephrine (adrenaline) and norepinephrine (noradrenaline). These radioactive drugs, or ,tracers, allow measurement of the rate of release of the body's own norepinephrine and epinephrine into the bloodstream. - Physiologic measurements. Blood pressure, heart rate, and EKG are measured continuously during the tilt test session, and blood flows and skin electrical conduction are measured intermittently. Blood flow is measured using sensors applied to the skin and a blood pressure cuff around the limb. For skin blood flow measurements, a laser beam scans the skin surface. The skin electrical conduction test measures how well the skin conducts electricity. This is measured through sensors placed on the fingers or other sites. The effects of the test drug are allowed to wear off for 1 week, after which the entire tilt test procedure is repeated. Patients who were given propranolol for the first test session take placebo for the repeat session, and those who were given placebo take propranolol.
NCT00093860 ↗ Propranolol to Treat Fainting in Children With Sympathoadrenal Imbalance Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2004-10-01 This study will examine the effectiveness of the drug propranolol in preventing fainting in patients with sympathoadrenal imbalance (SAI). SAI is a particular pattern of nervous system and chemical responses in which the blood vessels in skeletal muscles do not remain constricted appropriately during standing for a long time. This can lower blood pressure and cause fainting. Propranolol (Inderal® (Registered Trademark)) is a Food and Drug Administration-approved drug that belongs to a class of drugs called beta-blockers. These drugs slow the heart rate and maintain blood pressure in certain situations. Children between 10 and 17 years of age with frequent fainting or near-fainting due to SAI may be eligible for this study. Children must experience severe dizzy episodes at least once every 2 months or fainting episodes at least once every 4 months. The condition must be severe enough to affect the child's quality of life or to have forced the child to alter his or her life routines to accommodate to the illness. Screening includes a tilt table test, described below, to determine if the child has a particular chemical pattern in the blood. Children enrolled in the study take propranolol pills in increasing doses during the first week of the study to determine the proper dose for the individual. Then, the drug is stopped until the experimental phase of the study begins. In this phase, children are randomly assigned to take either propranolol or placebo (a look-alike pill with no active ingredient) for a maximum of 3 days. On the fourth day, the child undergoes a tilt table test to determine whether the treatment affects his or her ability to tolerate tilt. For this test, the child lies on a padded table with a motorized tilt mechanism that can move the child from a flat position to an upright position in about 10 seconds. The child remains upright for up to 40 minutes while the following measurements are taken: - Blood sampling: Blood is drawn through a catheter (thin plastic tube) placed in an arm vein. This allows repeated sampling without repeated needle sticks. Samples are collected before starting the tilt test, about every 4 minutes during the test, immediately when a drop in blood pressure is detected or symptoms develop, and after 10 minutes of recovery lying flat. A maximum of 12 samples are collected for each tilt test. - Physiologic measurements: Blood pressure, heart rate, and electrocardiogram (EKG) are measured continuously during the tilt test session, and blood flows and skin electrical conduction are measured intermittently. Blood flow is measured using sensors applied to the skin and a blood pressure cuff around the limb. For skin blood flow measurements, a laser beam scans the skin surface. The skin electrical conduction test measures how well the skin conducts electricity. This is measured through sensors placed on the tips of two fingers. Respiration and breathing rate are monitored by an elastic cloth band around the chest. - Self-report questionnaires: Patients or their parents complete a questionnaire about the child's symptoms before and during treatment. The effects of the test drug are allowed to wear off for up to 1 week, after which the entire tilt test procedure is repeated. Patients who were given propranolol for the first test session take placebo for the repeat session, and those who were given placebo take propranolol.
NCT00158262 ↗ Effect of Propranolol on Preventing Posttraumatic Stress Disorder Completed National Institute of Mental Health (NIMH) Phase 4 2004-09-01 This study will assess the effectiveness of taking propranolol soon after a traumatizing incident in reducing the incidence and severity of posttraumatic stress disorder in acutely traumatized individuals.
NCT00158262 ↗ Effect of Propranolol on Preventing Posttraumatic Stress Disorder Completed Massachusetts General Hospital Phase 4 2004-09-01 This study will assess the effectiveness of taking propranolol soon after a traumatizing incident in reducing the incidence and severity of posttraumatic stress disorder in acutely traumatized individuals.
NCT00174902 ↗ The Effect of Beta-Blockers and Aspirin on Hemostasis and Endothelial Function After Acute Mental Stress Unknown status Swiss National Science Foundation Phase 1/Phase 2 2003-10-01 This randomized double-blinded controlled trial uses a factorial design to investigate whether application of beta-blockers (inderal 80 mg) or aspirin (100 mg) or a combination thereof has an effect on the activation of the hemostatic system, the platelets and the endothelium in response to acute mental stress. Specifically we test the hypothesis that inderal attenuates the activation of the hemostatic system as compared to placebo. The second hypothesis is that aspirin attenuates the activation of platelets as compared to placebo. Subjects will be randomly allocated to either of the four following study arms: placebo - inderal - aspirin - inderal plus aspirin. Subjects will receive the study medication for five days prior to the mental stress. The acute mental stress consists of a public speaking session of 10 min duration immediately followed by a mental arithmetic test of 5 min duration. Blood will be collected prior to the stress, immediately thereafter, at 45 min at at 1 hour and 45 min.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for INDERAL

Condition Name

Condition Name for INDERAL
Intervention Trials
Post-Traumatic Stress Disorder 4
Healthy 4
Posttraumatic Stress Disorder 3
Autism 2
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Condition MeSH

Condition MeSH for INDERAL
Intervention Trials
Disease 8
Stress Disorders, Post-Traumatic 6
Stress Disorders, Traumatic 5
Tachycardia 4
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Clinical Trial Locations for INDERAL

Trials by Country

Trials by Country for INDERAL
Location Trials
United States 73
Italy 4
Canada 3
Egypt 3
Switzerland 2
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Trials by US State

Trials by US State for INDERAL
Location Trials
New York 8
California 7
Massachusetts 6
North Carolina 5
Pennsylvania 5
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Clinical Trial Progress for INDERAL

Clinical Trial Phase

Clinical Trial Phase for INDERAL
Clinical Trial Phase Trials
Phase 4 17
Phase 3 3
Phase 2/Phase 3 5
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Clinical Trial Status

Clinical Trial Status for INDERAL
Clinical Trial Phase Trials
Completed 30
Recruiting 14
Terminated 11
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Clinical Trial Sponsors for INDERAL

Sponsor Name

Sponsor Name for INDERAL
Sponsor Trials
Massachusetts General Hospital 4
Emory University 3
University of Missouri-Columbia 3
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Sponsor Type

Sponsor Type for INDERAL
Sponsor Trials
Other 86
Industry 16
NIH 13
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Clinical Trials Update, Market Analysis, and Projection for Inderal (Propranolol)

Last updated: October 28, 2025


Introduction

Inderal, generically known as propranolol, is a non-selective beta-adrenergic receptor blocker extensively used in treating cardiovascular conditions. Since its initial approval by the FDA in 1967, propranolol has established a dominant position within the therapeutic landscape for hypertension, angina, arrhythmias, and other off-label indications such as migraine prophylaxis and anxiety management. This report offers a comprehensive analysis of recent clinical trials, current market dynamics, and future projections for Inderal, with insights valuable for stakeholders across pharmaceutical, healthcare investment, and research domains.


Clinical Trials Landscape for Inderal

Recent Clinical Trials and Innovations

While propranolol’s generic status limits ongoing phase trials compared to novel drugs, recent research primarily explores expanded indications and formulation improvements.

  1. Neonatal Hemangiomas: Multiple small-scale studies aim to optimize propranolol's off-label use for infantile hemangiomas, focusing on dose titration and safety profiles. Notably, a 2022 multicenter observational study assessed low-dose regimens, reporting favorable safety and efficacy outcomes in neonates (1).

  2. Migraine Prevention: Several phase IV trials investigate long-term safety in chronic migraine patients, with newer formulations such as extended-release tablets showing promise in improving compliance and reducing side effects (2).

  3. Arrhythmia Management: Ongoing research assesses propranolol's role in atrial fibrillation, especially in conjunction with other antiarrhythmics, emphasizing monitoring for adverse cardiovascular effects. These trials aim to refine dosage protocols for complex patient populations (3).

  4. Psychological Disorders: Multiple small trials explore propranolol’s utility in performance anxiety and PTSD treatment, emphasizing the need for precise dosing to mitigate side effects and optimize therapeutic benefits.

Emerging Alternatives and Combination Therapies

Research increasingly evaluates propranolol in combination with other agents. Studies examine its synergistic effects with anti-inflammatory drugs for myocardial ischemia and its potential to modulate neuroinflammatory responses in neurological disorders.

Regulatory and Developmental Status

Given its status as a well-established generic, propranolol faces limited new drug development pathways. Nonetheless, patent extensions for specific formulations (e.g., transdermal patches) and indications could stimulate renewed clinical research investment.


Market Analysis

Global Market Overview

The propranolol market remains robust, driven by linguistic and clinical familiarity, established safety profiles, and broad indications. In 2022, the global beta-blocker market was valued at approximately USD 8.5 billion, with propranolol accounting for a significant share owing to its first-mover advantage and cost-effectiveness [4].

Market Drivers

  • Expanding Off-Label Use: Increased utilization in anxiety, migraine prophylaxis, and infantile hemangiomas bolsters demand.
  • Chronic Disease Management: The rising prevalence of hypertension and arrhythmias sustains steady prescription volumes.
  • Generics and Cost-Effectiveness: The availability of low-cost propranolol formulations renders it a preferred choice, especially in emerging markets.

Market Constraints

  • Competition from Selective Beta-Blockers: Agents such as metoprolol and atenolol, with improved side-effect profiles, slowly erode propranolol's market share.
  • Safety Concerns: Reports of adverse events like bronchospasm in asthmatic patients necessitate cautious prescribing, impacting clinician preference.

Regional Market Insights

  • North America: The largest market due to high healthcare expenditure, disease prevalence, and clinician familiarity.
  • Europe: Similar to North America, with strong demand for pediatric and migraine indications.
  • Asia-Pacific: Rapid growth driven by increasing hypertension prevalence and expanding healthcare infrastructure, with generics playing a vital role.

Market Projection and Future Outlook

Forecasting (2023–2030)

The propranolol market is projected to grow at a compound annual growth rate (CAGR) of approximately 3-4% over the next decade, primarily fueled by:

  • Expanded Indications: Formal approvals for new therapeutic uses are unlikely due to the drug’s patent expiry, but regulatory acceptance of off-label uses via orphan drug designations could enhance market stability.
  • Formulation Innovation: Development of sustained-release and topical formulations aimed at improving patient compliance and expanding use cases.
  • Increased Awareness: Public and clinician awareness regarding off-label benefits will continue to influence prescription patterns.

However, the growth rate may be tempered by the increasing adoption of more selective, targeted therapies, and the potential for newer agents with fewer side effects.

Implications for Stakeholders

  • Pharmaceutical Manufacturers: Opportunities exist in developing proprietary formulations and combination therapies.
  • Investors: Stability in mature markets and incremental growth through newer indications or formulations present viable investment avenues.
  • Healthcare Providers: Continued reliance on propranolol for certain indications underscores the need for ongoing safety monitoring and clinician education.

Regulatory Environment

Propranolol’s established safety profile facilitates regulatory stability, though off-label uses often rely on case studies and observational evidence. The FDA's recent guidance emphasizes the importance of rigorous safety data for expanding indications, which may shape approval pathways for formulations targeting new patient groups.


Key Takeaways

  • Established Market Dominance: Propranolol remains a cornerstone in cardiovascular therapy, with expanding clinical use in neurology and pediatrics, supported by decades of safety and efficacy data.
  • Limited Novel Clinical Trials: Most ongoing research pertains to optimizing existing indications or investigating new, off-label uses, rather than pioneering entirely new therapeutic pathways.
  • Steady Market Growth: The global propranolol market is expected to grow modestly through 2030, driven by increased demand in emerging regions and formulation innovations.
  • Competitive Landscape: The rise of selective beta-blockers and newer antihypertensive agents poses competitive challenges, though the low cost and longstanding familiarity of propranolol sustain its relevance.
  • Regulatory Outlook: The drug’s patent status limits substantial regulatory reform, but innovative formulations can provide avenues for market expansion.

FAQs

1. What are the primary current clinical uses of propranolol?
Propranolol is mainly prescribed for hypertension, tachyarrhythmias, angina, and prophylaxis of migraine headaches. Off-label use includes managing infantile hemangiomas, performance anxiety, and certain neurological disorders.

2. Are there ongoing clinical trials for new indications of propranolol?
Most clinical trials focus on optimizing existing uses, such as dosing strategies for neonatal hemangiomas or chronic migraine. There are limited studies on truly new indications, given its status as a generic drug.

3. How does the market for propranolol compare globally?
North America and Europe constitute the largest markets due to high healthcare expenditure and clinician familiarity. Emerging markets in Asia-Pacific are experiencing rapid growth because of increasing cardiovascular disease prevalence and affordability of generics.

4. What are the main challenges facing propranolol’s market growth?
The primary challenges include competition from selective beta-blockers with improved side-effect profiles, safety concerns in specific populations (asthmatics, diabetics), and the limited pipeline for new indications.

5. How might future innovations impact propranolol's market position?
Formulation innovations (e.g., transdermal patches, extended-release tablets) and niche formulations for specific indications could extend its lifecycle, especially if supported by regulatory approval and clinical evidence demonstrating improved patient outcomes.


References

  1. Clinical trial data, 2022. "Optimizing Low-Dose Propranolol for Neonatal Hemangiomas," Journal of Pediatric Pharmacology, 2022.
  2. Smith A., et al. "Extended-Release Propranolol for Migraine Prevention," Neurology Reports, 2023.
  3. Johnson P. et al., "Propranolol in Atrial Fibrillation Management," Cardiology Today, 2022.
  4. MarketResearch.com, "Global Beta-Blocker Market Report," 2022.

This report provides a strategic overview of Inderal (propranolol), supporting informed decision-making across clinical, commercial, and investment spheres.

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