Questions about Atrial Fibrillation? Get answers from our expert.

ranolazine (Oral route)

Pronunciation

ra-NOE-la-zeen

Commonly used brand name(s)

In the U.S.

  • Ranexa

Available Dosage Forms:

  • Tablet, Extended Release

Therapeutic Class: Antianginal

Uses For ranolazine

Ranolazine is used to treat chronic angina (chest pain). ranolazine is usually used together with other medicines, such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, or nitrates.

Slideshow: 2013 Drug News Round-Up: Top 20 Stories

ranolazine is available only with your doctor's prescription.

Before Using ranolazine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ranolazine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ranolazine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ranolazine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ranolazine in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving ranolazine.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ranolazine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ranolazine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amitriptyline
  • Amoxapine
  • Amprenavir
  • Atazanavir
  • Carbamazepine
  • Cisapride
  • Clarithromycin
  • Clomipramine
  • Cobicistat
  • Desipramine
  • Doxepin
  • Dronedarone
  • Fosamprenavir
  • Fosphenytoin
  • Imipramine
  • Indinavir
  • Itraconazole
  • Ketoconazole
  • Lopinavir
  • Mesoridazine
  • Nefazodone
  • Nelfinavir
  • Nortriptyline
  • Phenobarbital
  • Phenytoin
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Protriptyline
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Saquinavir
  • Sparfloxacin
  • St John's Wort
  • Thioridazine
  • Trimipramine

Using ranolazine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Afatinib
  • Ajmaline
  • Alfentanil
  • Alfuzosin
  • Amiodarone
  • Apomorphine
  • Aprepitant
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Astemizole
  • Azimilide
  • Azithromycin
  • Bedaquiline
  • Bretylium
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clozapine
  • Colchicine
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Dasatinib
  • Dihydroergotamine
  • Diltiazem
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Ergotamine
  • Erythromycin
  • Eslicarbazepine Acetate
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Formoterol
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Hydroquinidine
  • Ibutilide
  • Iloperidone
  • Ivabradine
  • Lapatinib
  • Levofloxacin
  • Lomitapide
  • Lovastatin
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Mifepristone
  • Mitotane
  • Moxifloxacin
  • Nilotinib
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pasireotide
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Pirmenol
  • Pixantrone
  • Pomalidomide
  • Prajmaline
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Quetiapine
  • Quinidine
  • Quinine
  • Romidepsin
  • Salmeterol
  • Sematilide
  • Simeprevir
  • Simvastatin
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Tetrabenazine
  • Tizanidine
  • Tocophersolan
  • Toremifene
  • Trabectedin
  • Trazodone
  • Trifluoperazine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Verapamil
  • Vilanterol
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Voriconazole
  • Ziprasidone

Using ranolazine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Digoxin
  • Metformin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ranolazine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use ranolazine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of ranolazine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart rhythm problems (eg, QT prolongation, long QT syndrome), or history of or
  • Kidney disease, severe—Use with caution. May make these conditions worse.
  • Liver cirrhosis—Should not be used in patients with this condition.

Proper Use of ranolazine

Take ranolazine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

ranolazine should come with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

You may take ranolazine with or without food.

Swallow the extended-release tablet whole. Do not crush, break, or chew it.

Dosing

The dose of ranolazine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ranolazine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release tablets):
    • For chronic angina:
      • Adults—At first, 500 milligrams (mg) two times per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 1000 mg two times per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of ranolazine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using ranolazine

If you will be taking ranolazine for a long time, it is very important that your doctor check you at regular visits for any problems or unwanted effects that may be caused by ranolazine. Blood tests may be needed to check for unwanted effects.

Do not use ranolazine together with carbamazepine (Tegretol®), clarithromycin (Biaxin®), nefazodone (Serzone®), phenobarbital, phenytoin (Dilantin®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rimactane®), rifapentine (Priftin®), medicine to treat fungus infections (eg, itraconazole, ketoconazole, Nizoral®, Sporanox®), medicine to treat HIV or AIDS (eg, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Norvir®, Viracept®), or St. John's wort.

Do not use ranolazine to treat a sudden onset of chest pain.

ranolazine can cause a change in the heart rhythm called prolongation of the QT interval. This condition may change the way your heart beats and can cause palpitations or fainting spells. Check with your doctor right away if you start having any of these symptoms.

ranolazine may cause acute kidney failure in some patients with severe kidney disease. Check with your doctor right away if you have the following symptoms: agitation, confusion, decreased urine output, depression, dizziness, headache, hostility, irritability, lethargy, muscle twitching, nausea, rapid weight gain, seizures, stupor, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

ranolazine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to ranolazine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Grapefruit and grapefruit juice may increase the effects of ranolazine by increasing the amount of medicine in the body. You should not eat grapefruit or drink grapefruit juice while you are taking ranolazine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

ranolazine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Dizziness
Less common
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • continuous ringing or buzzing or other unexplained noise in the ears
  • difficult or labored breathing
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of constant movement of self or surroundings
  • hearing loss
  • lightheadedness
  • rapid weight gain
  • sensation of spinning
  • tightness in the chest
  • tingling of the hands or feet
  • unusual weight gain or loss
Rare
  • Abnormal or decreased touch sensation
  • agitation
  • blood in the urine
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain or discomfort
  • chills
  • cold sweats
  • coma
  • confusion
  • decreased urine output
  • depression
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • headache
  • hostility
  • irritability
  • lethargy
  • muscle twitching
  • nausea
  • seizures
  • shakiness in the legs, arms, hands, or feet
  • slow or irregular heartbeat
  • stupor
  • sweating
  • trembling or shaking of the hands or feet
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Difficulty having a bowel movement (stool)
Less common
  • Dry mouth
  • stomach pain
Rare
  • Lack or loss of strength

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products.

Questions about Atrial Fibrillation? Get answers from our expert. Watch Video

Close
Hide
(web5)