Two medicines, side by side
Propranolol vs topiramate
Propranolol and topiramate are both labeled for migraine. Drugs@FDA records approvals of propranolol since 1967 and of topiramate since 1996. Pharmacies paid $0.0493 per propranolol 20 mg tablet and $0.0567 per topiramate 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the propranolol FDA label on DailyMed (effective January 15, 2026); the topiramate FDA label on DailyMed (effective June 1, 2026).
Highlights of the propranolol record
Propranolol (Inderal) · label of January 15, 2026
Used for
From the label: indicationsHypertension Propranolol hydrochloride tablets are indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol hydrochloride tablets are not indicated in the management of hypertensive emergencies. […]
On the market
- Earliest approval on file
- November 13, 1967
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.0493 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 4
Highlights of the topiramate record
Topiramate (Topamax) · label of June 1, 2026
Used for
From the label: indicationsTopiramate is indicated for: Epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older (1.1); adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox- Gastaut syndrome in patients 2 years of age and older (1.2) Preventive treatment of migraine […]
On the market
- Earliest approval on file
- December 24, 1996
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0567 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Source: FDA drug labels via openFDA (Propranolol label of January 15, 2026, Topiramate label of June 1, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do propranolol and topiramate differ on the record?
How each works, in its label's words: Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”; Topiramate, “The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to …”
Half-life, in each label's words: Propranolol, “The plasma half-life of propranolol is from 3 to 6 hours.”; Topiramate, “The mean plasma elimination half-life is 21 hours after single or multiple doses.”
Generics: propranolol since 1985; topiramate since 2003 (Drugs@FDA).
| Propranolol | Topiramate | |
|---|---|---|
| Labeled for | High blood pressure, Angina, Atrial fibrillation, Migraine | Seizures and epilepsy, Migraine |
| Pharmacologic class | beta-Adrenergic Blocker | n/a |
| How it works (label) | Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established. | The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and the … |
| Half-life (label) | The plasma half-life of propranolol is from 3 to 6 hours. | The mean plasma elimination half-life is 21 hours after single or multiple doses. |
| Earliest approval on file (Drugs@FDA) | November 13, 1967 | December 24, 1996 |
| First generic approved | July 30, 1985 | December 17, 2003 |
| Generic labelers (NDC) | 42 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0493 per tablet (Propranolol 20 mg tablet) | $0.0567 per tablet (Topiramate 100 mg tablet) |
| 12-month price change | -17% | -10% |
| Boxed warning | No | No |
| Shortage now | In shortage | No current entry |
| Recalls recorded | 4 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 71,660 | 91,067 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Topiramate label, drug interactionsBecause of the potential of topiramate to cause CNS depression, as well as other cognitive and/or neuropsychiatric adverse reactions, topiramate should be used with extreme caution if used in combination with alcohol and other CNS depressants.
Source: FDA drug labels via openFDA
What next?
- Alternatives to propranolol
- every medicine labeled for the same conditions