Ranolazine

Ranolazine is a prescription medication used to treat Angina. 

• Ranolazine is available under the following different brand names: Ranexa.

Adult dosage

Tablet, extended-release

• 500mg
• 1000mg

Angina

Adult dosage

• 500 mg orally twice daily initially; may increase to 1000 mg orally twice daily, if needed

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Ranolazine include:

• nausea, 
• constipation, 
• headache, and
• dizziness

Serious side effects of Ranolazine include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• fast or pounding heartbeats, 
• fluttering in the chest, 
• little or no urination, 
• painful or difficult urination, 
• swelling in the feet or ankles, 
• tiredness, and 
• shortness of breath

Rare side effects of Ranolazine include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Ranolazine has severe interactions with the following drugs:

• ceritinib
• cobicistat
• darunavir
• efavirenz
• eliglustat
• itraconazole
• ketoconazole
• Lefamulin
• ribociclib

Ranolazine has serious interactions with at least 136 drugs.

Ranolazine has moderate interactions with at least 217 other drugs.

Ranolazine has minor interactions with at least 35 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hepatic cirrhosis, including Child-Pugh class A (mild), B (moderate), and C (severe)
• Strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, saquinavir)
• CYP3A inducers (eg, carbamazepine, phenobarbital, phenytoin, rifampin, rifabutin, rifapentine, St. John’s wort)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Ranolazine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Ranolazine?”

Cautions

• Not for acute anginal episodes
• While ACS patients appear not to be at increased risk for proarrhythmia or sudden death, ranolazine has been shown to block I-Kr and cause dose-related QTc-interval prolongation
• Little data available on high doses (ie, over 1000 mg twice daily), long exposure, concomitant use with QT interval-prolonging drugs, or potassium channel variants causing prolonged QT interval
• Increased risk of QTc prolongation in patients with mild or moderate hepatic impairment
• Acute renal failure reported in some patients with severe renal impairment (CrCl less than 30 mL/min); discontinue if marked increase in creatinine occurs with increased BUN
• Individuals older than 75 years have higher incidence of adverse effects
• Causes small reductions in HbA1c in patients with diabetes; must not be considered a treatment for diabetes
• Avoid grapefruit products

Pregnancy and Lactation

• Use with caution in benefits outweigh risks during pregnancy.
• Lactation: Unknown if excreted in breast milk; discontinue or do not nurse