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Drug Interactions between Clolar and ranolazine

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

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Interactions between your drugs

Moderate

clofarabine ranolazine

Applies to: Clolar (clofarabine) and ranolazine

MONITOR: Coadministration with ranolazine may increase the plasma concentrations of drugs that are substrates of the organic cation transporter 2 (OCT2). The proposed mechanism is inhibition of OCT2-mediated renal tubular secretion by ranolazine, resulting in decreased clearance of drugs that are eliminated by this pathway such as metformin. When metformin 1000 mg twice daily was administered concomitantly with ranolazine 500 mg and 1000 mg twice daily in subjects with type 2 diabetes mellitus, metformin systemic exposure (AUC) increased by 40% and 80%, respectively, compared to administration of metformin alone.

MANAGEMENT: It may be advisable to monitor for altered efficacy and safety when an OCT2 substrate is coadministered with ranolazine, particularly in the elderly and patients with renal impairment. A dosage adjustment of the OCT2 substrate may be required.

References (3)
  1. EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
  2. (2023) "Product Information. Ranexa (ranolazine)." Gilead Sciences
  3. (2020) "Product Information. Corzyna (ranolazine)." Kye Pharmaceuticals Inc

Drug and food interactions

Major

ranolazine food

Applies to: ranolazine

GENERALLY AVOID: Grapefruit and grapefruit juice may significantly increase the plasma concentrations of orally administered ranolazine. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. 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.

MANAGEMENT: Patients treated with ranolazine should avoid consumption of grapefruit juice and other grapefruit products if possible. Otherwise, the dosage of ranolazine should be limited to 500 mg twice a day.

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

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.

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