Indications 

Ranolazine is a medication indicated for the management of chronic angina, a condition characterized by recurrent chest pain.  

Its therapeutic action involves the reduction in the frequency of angina attacks and the improvement of exercise tolerance. Notably, Ranolazine operates via a distinct mechanism compared to conventional angina medications, which enables its combination with other drugs, including nitrates, calcium channel blockers (e.g., amlodipine), and beta blockers (e.g., metoprolol).  

The drug’s mode of action involves enhancing myocardial oxygen utilization, leading to increased cardiac performance with reduced oxygen consumption. 

Uses and Dosage 

Prior to initiating ranolazine therapy, patients are advised to carefully review the Patient Information Leaflet, if provided by the pharmacist, both at treatment commencement and at each refill. Inquiries regarding the medication should be directed to the physician or pharmacist. 

Ranolazine is taken orally, usually twice a day, and may be consumed with or without food, as prescribed by the healthcare provider. Tablets should be swallowed whole and not crushed, chewed or split, to avoid the immediate release of the entire drug, which could raise the risk of adverse effects. 

Dosage of ranolazine is determined based on the patient’s medical history, response to therapy and any concomitant drug use. Inform the healthcare provider of all products used, including prescription, non-prescription and herbal products. The medication should not be taken in higher quantities than prescribed by the physician. 

To derive optimal benefits from the medication, take it at the same time every day and regularly as prescribed. Ranolazine should not be used to alleviate chest pain during an episode of angina. Alternative medications such as sublingual nitroglycerin should be used, as advised by the physician or pharmacist. 

Patients are advised to report to their healthcare provider if there is no improvement in their medical condition or if the condition worsens, such as the occurrence of more frequent chest pain. 

Side Effects 

Allergic Reactions

In case of an allergic reaction to Ranexa, seek immediate medical attention and look out for the following symptoms: 

• Hives 
• Difficulty breathing 
• Swelling of the face, lips, tongue or throat 

Severe Side Effects

Contact your healthcare provider immediately if you experience any of the following: 

• Lightheadedness 
• Chest pain accompanied by headache and severe dizziness 
• Rapid or pounding heartbeats 

If you encounter kidney problems such as: 

• Little or no urination 
• Painful or difficult urination 
• Swelling in your feet or ankles 
• Feeling tired or short of breath 

Inform your healthcare provider of any adverse reactions to the medication.  

Common Side Effects  

• Nausea 
• Constipation 
• Headache 
• Dizziness 

Caution 

Before taking ranolazine, inform your doctor or pharmacist if you have any allergies or allergic reactions to it, or any other inactive ingredients used in the medication. Your pharmacist can provide more information about the product and its potential allergens. 

Prior to using this medication, inform your doctor or pharmacist about your medical history, especially if you have liver problems like cirrhosis or kidney problems. 

Ranolazine may cause QT prolongation, a condition that affects the heart rhythm. In rare cases, QT prolongation can lead to serious or fatal fast/irregular heartbeat and other symptoms like severe dizziness and fainting that need immediate medical attention. 

The risk of QT prolongation can be increased if you have certain medical conditions or are taking other medications that cause QT prolongation. Before using ranolazine, inform your doctor or pharmacist about all the drugs you are taking, and if you have any of the following medical conditions: heart failure, slow heartbeat, QT prolongation in the EKG, or family history of certain heart problems such as sudden cardiac death. 

Your risk of QT prolongation can increase if you have low levels of potassium or magnesium in your blood, certain medical conditions like severe sweating, diarrhea, or vomiting, or use certain medications such as diuretics/”water pills.” Please consult with your doctor about the safe use of ranolazine. 

This drug can make you dizzy. Using alcohol or marijuana (cannabis) can increase your dizziness. Therefore, you should not drive, use machinery, or perform any task that requires alertness until you can do it safely. Limit alcoholic beverages and inform your doctor if you use marijuana (cannabis). 

Before undergoing any surgery, inform your doctor or dentist about all the products you use, including prescription drugs, nonprescription drugs, and herbal products. 

Older adults may be more susceptible to the side effects of this medication, particularly QT prolongation. 

During pregnancy, this medication should be used only when needed. Therefore, discuss the potential risks and benefits of using ranolazine with your doctor.