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Jul 24, 2024

Heart Health

Ranolazine for Chronic Chest Pain

Ranolazine, also known by its brand name Ranexa, is a prescription medication used to treat chronic chest pain, also known as angina. Angina is characterized by chest pain, pressure, tightness, or discomfort, typically caused by reduced blood flow to the heart muscle.

  • Reduces Frequency of Chest Pain
  • Improves Exercise Stamina

How Ranolazine Works

While the exact mechanism of action is not fully understood, ranolazine is known to work by:

  • Reducing myocardial oxygen demand.
  • Decreasing ventricular tension and oxygen consumption. This means it helps your heart use oxygen more efficiently, allowing it to perform more work with less oxygen.

Ranolazine works differently from other antianginal medications like calcium channel blockers (CCBs), beta-blockers (e.g., metoprolol), and nitrates. Therefore, it can be taken in addition to these other treatments for better management of angina.

Dosage and Administration

Ranolazine ER (extended-release), known by the brand name Ranexa, is taken orally. The typical starting dosage is 500 mg twice a day, which may be increased to 1000 mg twice daily based on your clinical symptoms and treatment response.

  • Starting Dose: 500 mg twice a day
  • Maximum Dose: 1000 mg twice a day
Administration
  • With or Without Food: Ranolazine can be taken with or without food.
  • Do Not Chew, Break, or Crush: Swallow the tablets whole.
  • Missed Dose: If you miss a dose, take the next dose at the scheduled time. Do not double the dose to make up for the missed one.

Side Effects

Common side effects include:

  • Dizziness
  • Headache
  • Constipation
  • Nausea
  • Fatigue

Serious side effects include:

  • Liver cirrhosis: This is long-term liver damage that can lead to liver failure or scarring.
  • Renal issues: These may include minimal or no urination, painful or difficult urination, swelling in the ankles or feet, and feelings of fatigue or shortness of breath.
  • Faintness or lightheadedness
  • Heart rhythm issues: This can manifest as a fluttering sensation in the chest or rapid, pounding heartbeats.

Additionally, ranolazine can cause a condition called QT prolongation, which affects the rhythm of your heart. In rare cases, this can lead to dangerous fast or irregular heartbeats, especially if you're also taking other medications that affect your heart rhythm. If you notice any concerning symptoms while taking ranolazine, it's important to seek medical attention promptly.

Interactions

Drug interactions can alter how medications function or increase the risk of significant side effects. Several medications can affect how ranolazine works. It’s important to avoid grapefruits and grapefruit juice while taking ranolazine. Always inform your doctor and pharmacist if you are starting any new medications while on ranolazine.

  • Antifungals: Itraconazole, ketoconazole
  • Antibiotics: Clarithromycin
  • HIV Protease Inhibitors: Clarithromycin
  • Rifamycins: Indinavir, nelfinavir, saquinavir
  • Antivirals: Ritonavir
  • Anti-Seizure Medications: Carbamazepine, phenobarbital, phenytoin
  • Herbal Supplements: St. John’s wort

These medications can impact how ranolazine is eliminated from your body, potentially altering its effectiveness. Always consult your healthcare provider before starting or stopping any medications.

Speak with Your Doctor

Ranolazine is relatively considered a safe and effective medication when taken appropriately (as prescribed by your doctor). Talk to your doctor today about using Ranolazine and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

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