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Ranolazine ER
Ranolazine ER is an extended-release antianginal medication used to treat chronic angina (chest pain). It works differently from other angina medications by improving how the heart functions without significantly affecting heart rate or blood pressure. Ranolazine is typically prescribed when other medications, like nitrates or beta-blockers, do not sufficiently control angina symptoms.
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Frequently Asked Questions
How long does it take for Ranolazine ER to start working?
Ranolazine typically starts to reduce angina symptoms within a few days of starting treatment, but full effects may take 1 to 2 weeks.
Can Ranolazine ER be used for acute chest pain?
No, Ranolazine ER is not for acute angina attacks. You should use nitroglycerin for sudden chest pain.
Can I take Ranolazine ER with other heart medications?
Yes, Ranolazine ER can be used in combination with other heart medications like beta-blockers, calcium channel blockers, or nitrates for better control of angina. Always consult your healthcare provider.
Does Ranolazine ER affect blood pressure?
Ranolazine ER typically has little to no effect on blood pressure or heart rate, making it a good option for people who cannot tolerate significant blood pressure changes.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose and continue your regular schedule. Do not double up on doses.
Comprehensive Drug Guide
How Does Ranolazine ER Work?
Ranolazine works by inhibiting the late sodium current in heart muscle cells. This reduces the sodium and calcium overload in the heart, helping the heart to work more efficiently and reducing the oxygen demand, which relieves angina symptoms.
Common Dosages
- 500 mg extended-release tablets
- 1000 mg extended-release tablets
Typical Dosing
- The usual starting dose is 500 mg twice daily, which may be increased to 1000 mg twice daily based on the patient's response and tolerability.
Typical Dosing
FDA Approved Indications
- Chronic angina
Who Shouldn't Take Ranolazine ER?
- 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 Ranolazine ER as prescribed, twice daily, with or without food. Do not crush, break, or chew the tablet.
- Ranolazine does not relieve acute angina attacks. For sudden chest pain, use nitroglycerin as directed by your healthcare provider.
- Avoid grapefruit and grapefruit juice, as they can increase the levels of ranolazine in your blood.
- If you experience dizziness, fainting, or signs of heart rhythm problems, seek medical attention.
Side Effects of Ranolazine ER
Common Side Effects
- Dizziness
- Constipation
- Nausea
- Headache
Uncommon/Severe Side Effects
- QT prolongation (irregular heartbeats)
- Severe allergic reactions (e.g., swelling, rash, breathing difficulties)
Risks and Warnings of Ranolazine ER
- QT Prolongation: Ranolazine ER may cause QT prolongation, which can lead to abnormal heart rhythms. Routine ECG monitoring may be necessary in some patients.
- Liver and Kidney Function: Use with caution in patients with moderate liver or kidney impairment as the drug may accumulate and increase the risk of side effects.
- Drug Interactions: Avoid combining Ranolazine with strong CYP3A inhibitors or inducers as they can significantly affect drug levels.
Interactions with Ranolazine ER
Common Drug Interactions
- CYP3A inhibitors (e.g., ketoconazole, ritonavir): Can increase the levels of ranolazine, leading to an increased risk of side effects.
- CYP3A inducers (e.g., rifampin, phenytoin): Can lower the levels of ranolazine, reducing its effectiveness.
- QT-prolonging drugs (e.g., sotalol, amiodarone): Combining with Ranolazine may increase the risk of serious heart rhythm problems.
Alternatives to Ranolazine ER
- Amlodipine: A calcium channel blocker often used for angina and high blood pressure.
- Beta-blockers (e.g., metoprolol, atenolol): Reduce heart rate and workload on the heart.
- Nitrates (e.g., nitroglycerin, isosorbide mononitrate): Typically used to treat or prevent angina attacks.
