ranolazine at a glance
Medicine class
Anti-anginal cardiac treatment
Licensed role
Add-on symptomatic treatment for stable angina in adults
Tablet type
Prolonged-release tablet that must be swallowed whole
Food
May be taken with or without food; avoid grapefruit juice
Angina attacks
Not a rescue treatment; follow the prescribed angina-attack plan
What is ranolazine used for?
The selected product is licensed for:
Add-on symptomatic treatment of stable angina in adults whose symptoms are inadequately controlled by, or who cannot tolerate, first-line anti-anginal treatments such as beta blockers or calcium-channel blockers.
How does ranolazine work?
Ranolazine inhibits the late sodium current in heart-muscle cells. This reduces abnormal sodium and calcium accumulation during ischaemia, helping the heart muscle relax more efficiently without relying mainly on lowering heart rate or blood pressure.
ranolazine preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 375 mg, 500 mg, 750 mg
How to take ranolazine
Follow the prescription label. Swallow prolonged-release tablets whole with water; do not crush, chew, suck, split or break them because this can alter release of the medicine. They may be taken with or without food, but grapefruit juice should be avoided.
Tell the prescriber if dizziness, nausea or vomiting becomes troublesome.
Do not drive or operate machinery if dizziness, blurred or double vision, confusion or coordination problems occur.
ranolazine side effects
Common or expected effects
- Constipation
- Dizziness
- Headache
- Nausea or vomiting
- Weakness
Get urgent medical advice
- Swelling of the face, tongue or throat, hives, or difficulty breathing or swallowing
- Fainting or a new concerning heartbeat disturbance
- Very little or no urine
- Severe confusion, muscle twitching, cramps or reduced consciousness
ranolazine in pregnancy
Human pregnancy information is limited, and animal studies found embryo toxicity. Product information says ranolazine should not be used during pregnancy unless clearly necessary; pregnancy or plans to conceive require prompt prescriber or cardiology review.
ranolazine while breastfeeding
It is unknown whether ranolazine enters human milk, and risk to a breastfed child cannot be excluded. Product information advises against use while breastfeeding; specialist review should consider treatment need and better-evidenced alternatives.
ranolazine interactions
A full prescription, non-prescription and herbal-medicine review is important because ranolazine has several clinically significant interactions.
Potent CYP3A4 inhibitors, including clarithromycin, azole antifungals and HIV protease inhibitors
Can markedly raise ranolazine exposure and are contraindicated with the selected product.
Diltiazem, verapamil, erythromycin, fluconazole or ciclosporin
Can increase ranolazine levels and adverse effects, requiring careful clinical review.
Rifampicin, carbamazepine, phenytoin, phenobarbital or St John’s wort
Can substantially reduce ranolazine exposure and effectiveness; concurrent use should be avoided.
Common questions about ranolazine
Answers are fully visible for fast scanning and source review.
What is ranolazine used for?
It is added to other treatment to reduce stable-angina symptoms when first-line anti-anginal medicines are insufficient or not tolerated.
Does ranolazine stop an angina attack?
No. It is ongoing symptom-control treatment, not a rescue medicine; follow the prescribed angina-attack plan and call 999 if pain does not settle as directed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.