ranolazine (Oral route)Pronunciation
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Tablet, Extended Release
Therapeutic Class: Antianginal
Chemical Class: Piperazine (class)
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.
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:
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.
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.
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.
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.
- St John's Wort
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.
- Arsenic Trioxide
- Dabigatran Etexilate
- Doxorubicin Hydrochloride Liposome
- Morphine Sulfate Liposome
- Perflutren Lipid Microsphere
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Vincristine Sulfate Liposome
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.
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.
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.
- For chronic angina:
If you miss a dose of ranolazine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
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
- 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
- rapid weight gain
- sensation of spinning
- tightness in the chest
- tingling of the hands or feet
- unusual weight gain or loss
- Abnormal or decreased touch sensation
- blood in the urine
- blurred vision
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- chest pain or discomfort
- cold sweats
- decreased urine output
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- muscle twitching
- shakiness in the legs, arms, hands, or feet
- slow or irregular heartbeat
- 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)
- Dry mouth
- stomach pain
- 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)
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