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Ranexa
Ranexa (ranolazine) is a medication used to treat chronic angina (chest pain). Unlike other medications that primarily work by affecting heart rate or blood pressure, Ranexa improves blood flow to help the heart work more efficiently, reducing the frequency and severity of angina attacks. It belongs to a class of drugs called antianginals and is typically prescribed when other medications have not adequately controlled symptoms.
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Frequently Asked Questions
How long does it take for Ranexa to start working?
Ranexa typically begins to reduce angina symptoms within a few days of starting treatment, but the full effect may take 1 to 2 weeks.
Can Ranexa be used for acute chest pain?
No, Ranexa is not used to treat acute angina attacks. You should use nitroglycerin as prescribed by your healthcare provider for sudden chest pain.
Can I take Ranexa with other heart medications?
Yes, Ranexa can be used with other heart medications such as beta-blockers, calcium channel blockers, and nitrates. Your healthcare provider will determine the best combination for your condition.
Does Ranexa affect blood pressure?
Ranexa has little effect on blood pressure or heart rate. However, in some patients, it may cause dizziness or fainting, especially if they are taking other medications that lower blood pressure.
What should I do if I miss a dose?
Take the missed dose as soon as you remember, unless it is close to the time of your next dose. Do not double up on doses.
Comprehensive Drug Guide
How Does Ranexa Work?
Ranexa works by inhibiting the late phase of the sodium current in heart muscle cells. This reduces the sodium-induced calcium overload in the heart, improving heart function and helping to reduce the symptoms of angina without significantly affecting heart rate or blood pressure.
Common Dosages
- 500 mg extended-release tablets
- 1000 mg extended-release tablets
Typical Dosing
- The typical starting dose is 500 mg twice daily, which may be increased to 1000 mg twice daily based on patient response and tolerability.
Typical Dosing
FDA Approved Indications
- Chronic angina
Who Shouldn't Take Ranexa?
- Severe liver impairment
- Concurrent use of strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin)
- Known hypersensitivity to ranolazine or its components
Advice From The Pharmacist
- Take Ranexa twice daily, with or without food. Swallow the tablet whole—do not crush, break, or chew it.
- Ranexa does not relieve acute angina attacks. For sudden chest pain, use a nitroglycerin tablet as directed by your healthcare provider.
- Avoid grapefruit or grapefruit juice while taking Ranexa, as it can interfere with the metabolism of the drug.
- If you experience dizziness or fainting, contact your healthcare provider, as these may be signs of low blood pressure.
Side Effects of Ranexa
Common Side Effects
- Dizziness
- Headache
- Constipation
- Nausea
Uncommon/Severe Side Effects
- QT prolongation (irregular heart rhythms)
- Severe allergic reactions (e.g., rash, swelling, difficulty breathing)
Risks and Warnings of Ranexa
- QT Prolongation: Ranexa may cause QT prolongation, which can lead to serious heart rhythm disturbances. Routine ECG monitoring may be required in some patients.
- Renal and Hepatic Impairment: Use caution in patients with moderate to severe kidney or liver impairment, as the drug may accumulate and lead to toxicity.
- Drug Interactions: Avoid concurrent use with strong CYP3A inhibitors or inducers, as these can significantly alter ranolazine levels.
Interactions with Ranexa
Common Drug Interactions
- CYP3A inhibitors (e.g., ketoconazole, clarithromycin): May increase ranolazine levels and the risk of side effects.
- CYP3A inducers (e.g., rifampin, phenytoin): May reduce the effectiveness of Ranexa by lowering drug levels.
- QT-prolonging drugs (e.g., sotalol, amiodarone): Combining with Ranexa may increase the risk of heart rhythm issues.
Alternatives to Ranexa
- Amlodipine: A calcium channel blocker often used for angina and high blood pressure.
- Beta-blockers (e.g., metoprolol, atenolol): Used to reduce heart rate and prevent angina.
- Nitrates (e.g., nitroglycerin, isosorbide mononitrate): Often used to prevent or treat angina.
