Key takeaways
Propranolol is a prescription beta blocker used for high blood pressure, heart conditions, migraines, tremor, and situational anxiety.
The top alternatives to propranolol include Inderal LA, Toprol XL, Coreg, Cardizem CD, and Nurtec, each offering different benefits and side effects compared to propranolol.
Natural alternatives to propranolol, such as a low-salt diet, exercise, and supplements, can also help, but should not take the place of propranolol treatment.
Propranolol is a prescription beta blocker that is used for cardiac conditions, such as hypertension, atrial fibrillation, or angina, as well as tremors or migraine prevention. Propranolol is also used off-label to relieve performance anxiety. Except for anxiety, propranolol is a long-term daily treatment. There are a number of alternative prescription drugs available if propranolol is not effective or if side effects are a problem.
What can I take in place of propranolol?
The first stop in the search for potential propranolol alternatives does not even require leaving the beta blocker family. Depending on the specific use, there may be compelling reasons for simply changing to a different drug within the class.
If moving away from the drug class makes the most sense, then the best alternative will depend on what medical condition propranolol is being taken for. Options for migraine prevention are quite different from options for atrial fibrillation. With that said, let’s delve into the details to offer a better understanding of the available alternatives.
Propranolol alternatives cost comparison |
|||
|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Propranolol | $41 for 60, 10 mg tablets | $6 for 60, 10 mg tablets of generic propranolol at Walmart | See latest prices |
| Inderal LA (long-acting propranolol) | $2,290 for 30, 60 mg capsules | $14 for 30, 60 mg capsules of generic Inderal LA at Walgreens | See latest prices |
| Toprol XL (metoprolol extended-release) | $161 for 90, 25 mg tablets | $9 for 90, 25 mg tablets of generic Toprol XL at Kroger | See latest prices |
| Coreg (carvedilol) | $1,138 for 60, 12.5 mg tablets | $6 for 60, 12.5 mg tablets of generic Coreg at Kroger | See latest prices |
| Cardizem CD (diltiazem HCl ER) | $3,128 for 90, 120 mg capsules | $22 for 90, 120 mg capsules of generic Cardizem CD at Food Lion | See latest prices |
| Nurtec (rimegepant) | $1,415 for 8 disintegrating tablets | $923 for 8 disintegrating tablets of brand-name Nurtec at Kroger | See latest prices |
Top 5 propranolol alternatives
The following are some of the most common alternatives to propranolol.
1. Inderal LA
Convenience is not a trivial matter when it comes to drug dosing. The more times we take a medication each day, the more chances we have to forget it. Propranolol is a short-acting drug, with its concentration peaking in the blood about 1 to 4 hours after taking it. That characteristic is beneficial if it is being taken to prevent symptoms of performance anxiety, like shakiness before a speech. On the other hand, if it is being taken for blood pressure control in hypertension or heart rate control in atrial fibrillation, a long-acting version of propranolol, such as Inderal LA, may be more convenient.
2. Toprol XL
Propranolol is considered a non-selective beta blocker, meaning it blocks both beta-1 and beta-2 receptors. Beta-2 receptors are scattered throughout the body, and blocking them can lead to side effects, including bronchospasm. Toprol XL, on the other hand, is considered a selective beta-1 blocker. Switching to a beta blocker that is selective for beta-1 receptors may be preferred for people with respiratory conditions, such as asthma or COPD, because they mainly target receptors in the heart. Toprol XL is a popular alternative with more selective beta-blocking abilities and a once-daily dosing feature.
3. Coreg
Some beta blockers block alpha receptors, which helps relax and widen your arteries. This relaxation lowers blood pressure more effectively. If you need stronger blood pressure control than propranolol offers, a drug that blocks both beta and alpha receptors, Coreg (carvedilol), might be a better option.
4. Cardizem CD
Suppose propranolol or other beta blockers are ineffective or problematic due to common side effects. In that case, Cardizem CD (diltiazem ER) is a non-dihydropyridine calcium channel blocker that has many of the same potential benefits by reducing both heart rate and blood pressure.
Exceptions would be those who could also benefit from beta-blockade for heart disease, including anyone who needs heart rate control for atrial fibrillation or angina prevention in coronary artery disease.
5. Nurtec
Besides cardiac and blood pressure uses, propranolol’s other niche is migraine prevention. Until recent years, the alternatives to beta blockers for reducing migraine frequency amounted to anti-epileptic pills, like Topamax (topiramate) and Depakote (divalproex sodium), or off-label use of antidepressant drugs, such as amitriptyline. Calcitonin gene-related peptide (CGRP) inhibitors like Nurtec (rimegepant) have added a new angle to approaching migraine treatment. Nurtec has FDA indications for acute migraine relief and prevention.
Nurtec is only available as a brand-name product, making it considerably more expensive than propranolol. To help lower the price of Nurtec or propranolol alternatives, get a SingleCare prescription discount card, or download the SingleCare app, to present a Nurtec coupon to pharmacy staff at pick-up. SingleCare is free to use and available to everyone. Registered members can save even more, and it’s fast and free to join.
Related: Migraine Financial Assistance & Resources
Natural alternatives to propranolol
While natural alternatives aren’t an equivalent substitute for any of propranolol’s uses, they may help support the medication’s uses. For example, a low-salt diet, exercise, and weight loss can assist in hypertension management. Likewise, a routine of sleep, exercise, and meals may be helpful for migraine prevention. Propranolol alternatives for tremor include limb weights and reducing caffeine intake.
Besides lifestyle measures, over-the-counter supplements are another option to reduce the need for medications. Potatoes, magnesium, fish oil, fiber, protein, and folate can reduce blood pressure, but the effects are modest. Natural alternatives to propranolol for migraines include coenzyme Q10, riboflavin, and magnesium.
None of these alternatives has been well studied, and none should be substituted for a prescribed medication without discussing it fully with the prescribing healthcare provider.
How to switch to a propranolol alternative
Getting the medical advice of your healthcare provider is the next step in switching to a propranolol alternative. They’ll review medical history and any health conditions, a list of prescription drugs, and the different over-the-counter pills taken. Ultimately, you should be able to leave the appointment with an understanding of either why propranolol is the right choice or which alternative is better.
The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jul. 14, 2026. Prices vary by pharmacy. Visit our coupon page for updated drug prices at pharmacies near you.
- An evidence-based review of oral magnesium supplementation in the preventive treatment of migraine, Cephalalgia (2015)
- Beta adrenergic blocking agents, LiverTox (2018)
- Beta blockers, StatPearls (2023)
- Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials, BMJ (2013)
- Effectiveness of high-dose riboflavin in migraine prophylaxis: a randomized controlled trial, Neurology (1998)
- Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial, Neurology (2005)
- Essential tremor, StatPearls (2023)
- Herbal treatment for anxiety: Is it effective?, Mayo Clinic (2024)
- Physical activity as a critical component of first-line treatment for elevated blood pressure or cholesterol: who, what, and how?: a scientific statement from the American Heart Association, Hypertension (2021)
- Propranolol, StatPearls (2023)
- Propranolol hydrochloride tablet prescribing information, DailyMed (NIH National Library of Medicine) (2024)
- Propranolol versus other selected drugs in the treatment of various types of anxiety or stress, with particular reference to stage fright and post-traumatic stress disorder, International Journal of Molecular Sciences (2022)
- The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients, New England Journal of Medicine (1981)
- The use of nonselective beta blockers for treatment of portal hypertension, Gastroenterology & Hepatology (2017)
- Medically accurate: SingleCare’s Medical Review Board analyzes all of our content to confirm it’s in line with current medical advice.
- Evidence-based: Our content is sourced from reputable U.S.-based healthcare professionals and peer-reviewed research.
- Trustworthy: All of SingleCare’s content goes through a multi-phase review process by our writers, editors, and Medical Board in order to provide clear and credible information.