Uses
What is ranolazine used for?
Ranolazine is commonly used to prevent chest pain (angina) caused by a type of heart disease (coronary artery disease).
Ranolazine may also be used for other conditions as determined by your healthcare provider.
How does ranolazine work (mechanism of action)?
Ranolazine may reduce how often you have chest pain by helping your heart to work better with less oxygen. It seems to do this without changing your blood pressure or heart rate.
How is ranolazine supplied (dosage forms)?
Brands and other names
- Aspruzyo Sprinkle
- Ranexa
Dosage forms and strengths
- 500 mg/sachet, 1000 mg/sachet extended-release oral granules
- 500 mg, 1000 mg extended-release oral tablets
How should I store ranolazine?
Ranolazine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of ranolazine?
The most common side effects of ranolazine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Dizziness
- Headache
- Constipation
- Nausea
There may be other side effects of ranolazine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of ranolazine?
While less common, the most serious side effects of ranolazine are described below, along with what to do if they happen.
Severe Allergic Reactions. Ranolazine may cause allergic reactions, which can be serious. Stop taking Ranolazine and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Heart Rhythm Changes. Ranolazine may cause a rare dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as fast or skipping heartbeat.
Kidney Damage. Kidney damage can happen when taking ranolazine. Your healthcare provider will likely check labs to monitor for kidney damage after you start taking ranolazine. Keep all appointments to have your blood checked. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.
- Reduced need to pee
- Swelling in your feet, ankles, or legs
- Weakness or unusual tiredness
- Difficulty catching your breath or chest pain/pressure
- Confusion
- Nausea
- Seizures
Warnings & Precautions
Who should not use ranolazine?
Allergies to Ingredients. People who are allergic to any of the following should not take ranolazine.
- Ranolazine
- Aspruzyo Sprinkle
- Ranexa
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific ranolazine products they stock.
Drug Interactions. Ranolazine should not be taken while you are using certain other medicines. Before taking ranolazine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Cirrhosis. Ranolazine should not be taken if your liver has scars (cirrhosis). If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.
What should I know about ranolazine before using it?
Do not take ranolazine unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Ranolazine is taken to reduce how often you have chest pain. You should not take it to treat an episode of chest pain.
Do not share ranolazine with other people, even if they have the same condition as you. It may harm them.
Keep ranolazine out of the reach of children.
Swallow ranolazine extended-release tablets whole. Do not crush, break, or chew them.
Sprinkle ranolazine granules on about a tablespoonful of soft food, such as applesauce. Eat the soft food right away, without chewing or crushing the granules. Ranolazine granules can also be given through a feeding tube. Following the “Instructions for Use” that come with ranolazine granules if you need to take it through a feeding tube. Ask your pharmacist or healthcare provider if you have any questions about how to take ranolazine granules.
If you continue to have chest pain or discomfort after you start taking ranolazine, tell your healthcare provider.
Ranolazine may affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how ranolazine affects you.
What should I tell my healthcare provider before using ranolazine?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if ranolazine is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Personal or family history of heart failure or other heart problems, such as QT prolongation
- Liver problems
- Kidney problems
Pregnancy. It is not known if or how ranolazine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if ranolazine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take ranolazine while breastfeeding.
Interactions
Does ranolazine interact with foods or drinks?
It is best to limit the amount of grapefruit, grapefruit juice, and other products that have grapefruit in them while taking ranolazine. Grapefruit may increase ranolazine levels in your blood and cause serious side effects.
Do not drink alcohol while taking ranolazine extended-release oral granules. Alcohol changes how quickly the medicine is released in your body and can increase side effects. It is not known if drinking alcohol will affect ranolazine extended-release tablets. The risk of dizziness may be increased if you drink alcohol while taking ranolazine.
Does ranolazine interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking ranolazine.
- Ketoconazole, itraconazole (Spranox, Tolsura), or fluconazole (Diflucan), which is medicine used for fungal infections
- Clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
- Cyclosporine (Gengraf, Neoral, Sandimmune, and others), tacrolimus, or sirolimus, which is a medicine that suppresses your immune system
- Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
- Nefazodone, which is a medicine commonly used for depression
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- A statin, such as simvastatin (FloLipid, Zocor) or lovastatin (Altoprev, Mevacor), which is a medicine to lower cholesterol
- An antipsychotic, which is a medicine for certain mental health conditions
- A medicine used to treat nausea and vomiting from cancer treatment
- Metformin, which is a medicine commonly used for diabetes
- Ritonavir (Norvir), lopinavir/ritonavir (Kaletra), or nelfinavir (Viracept), which is a medicine commonly used to treat HIV
- Rifampin (Rifadin) or rifapentine (Priftin), which is a medicine commonly used to treat an infection called tuberculosis
- Rifabutin (Mycobutin), which is a medicine used to prevent Mycobacterium avium complex infection
- Any medicine for seizures, such as carbamazepine, phenytoin, or phenobarbital
- Medicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as quinidine, dofetilide, sotalol, or amiodarone
- Diltiazem (Cardizem CD and others), which is a medicine used for high blood pressure and other conditions
- Verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or chest pain
- St. John’s wort, which is a supplement that may be used to treat depression
Some other medicines may alter the blood levels of ranolazine, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with ranolazine. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much ranolazine?
If you or someone else has taken too much ranolazine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of ranolazine?
If you miss a dose, skip the missed dose. Take your next dose when you normally would. Do not take double or extra doses.
Are you currently using Ranolazine?
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