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Drug Interactions between Chloromycetin and ranolazine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

chloramphenicol ranolazine

Applies to: Chloromycetin (chloramphenicol) and ranolazine

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of ranolazine, which is primarily metabolized by the isoenzyme. Because ranolazine prolongs QT interval in a dose-dependent manner, high plasma levels of ranolazine may increase the risk of ventricular arrhythmias such as ventricular tachycardia, ventricular fibrillation, and torsade de pointes. In pharmacokinetic studies, plasma levels of ranolazine (1000 mg twice a day) were increased 3.2-fold by the potent CYP450 3A4 inhibitor, ketoconazole (200 mg twice a day), and 1.8- to 2.3-fold by the moderately potent inhibitor diltiazem (180 to 360 mg/day). Plasma levels of ranolazine (750 mg twice a day) were increased about 2-fold by the CYP450 3A4 and P-glycoprotein inhibitor, verapamil (120 mg three times a day).

MANAGEMENT: The dosage of ranolazine should not exceed 500 mg twice a day when coadministered with moderate inhibitors of CYP450 3A4, including but not limited to diltiazem, verapamil, aprepitant, erythromycin, fluconazole, and grapefruit juice. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

References

  1. (2006) "Product Information. Ranexa (ranolazine)." Calmoseptine Inc

Drug and food interactions

Major

ranolazine food

Applies to: ranolazine

You may take ranolazine with or without food, but should try to take it the same way every time. Grapefruit and grapefruit juice should be avoided if possible. Grapefruit juice can increase the levels of ranolazine in your body. High blood levels of food can occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with ranolazine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.