Ranolazine ER

Class
Antianginal agents
Subclass
Late sodium current inhibitors
Substance name
Ranolazine ER
Brand names
Ranexa®
Common formulations
Film-coated tablet
Dosage and administration
Adults patients
Stable angina
•
Start at: 500 mg PO BID
•
Maintenance: 500-1,000 mg PO BID
•
Maximum: 2,000 mg per day
AF • Pharmacological cardioversion • Off-label
•
1,500 mg PO once
Administered in combination with intravenously amiodarone.
Indications for use
Labeled indications
Adults
•
Treatment of stable angina
Off-label indications
Adults
•
Treatment of AF (pharmacological cardioversion)
Safety risks
Contraindications
Hypersensitivity to ranolazine or its components
Liver cirrhosis
Concomitant use of CYP3A4 inducers
Concomitant use of potent CYP3A4 inhibitors
Warnings and precautions
AKI
•
Use caution in patients with severe renal impairment. Discontinue ranolazine if acute renal failure develops.
Increased serum ranolazine levels
•
Use caution in patients taking moderate CYP3A4 inhibitors or with the use of grapefruit juice. Maximal dose of 500 mg BID.
Prolonged QT interval
•
Use caution in all patients, especially with known QT prolongation, congenital long QT syndrome, or taking other QT-prolonging drugs.
Specific populations
Renal impairment
CrCl ≥ 30 mL/min
•
Use acceptable. No dose adjustment required.
CrCl < 30 mL/min
•
Use with caution.
Renal replacement therapy
Continuous renal replacement
•
Avoid use as much as possible.
Intermittent hemodialysis
•
Avoid use as much as possible.
Peritoneal dialysis
•
Avoid use as much as possible.
Hepatic impairment
Any severity
•
Do not use.
Pregnancy and breastfeeding
Pregnancy
All trimesters
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in animals.
Breastfeeding
Use only if benefits outweigh potential risks.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Bradycardia, diaphoresis, hypotension, orthostatic hypotension, peripheral edema, abdominal pain, asthenia, blurred vision, confusion, constipation, dizziness, dry mouth, dyspepsia, dyspnea, headache, hematuria, loss of appetite, nausea, palpitations, syncope, tinnitus, vertigo, vomiting
Uncommon < 1%
•
Angioedema, ↓ WBC count, ↓ blood glucose, ↓ platelet count, ↑ BUN, ↑ blood eosinophil count, pancytopenia, pulmonary fibrosis, renal failure, hypoesthesia, paresthesia, tremor, urine discoloration
Unknown frequency
•
Myoclonus, ↑QT interval, dysuria, hallucinations, pruritus, skin rash, urinary retention
Interactions
Drug(s)
Check Interactions
Reset

What did you think about this content?

Create free account

Sign up for free to access the full drug resource