How does Ranexa work for chronic angina. What are the recommended dosages for Ranexa. What are the potential side effects and drug interactions of Ranexa. How should Ranexa be taken properly. Who should avoid using Ranexa. What precautions should be taken when using Ranexa.

What is Ranexa and How Does it Work?

Ranexa, also known by its generic name ranolazine, is a medication primarily used to treat chronic angina, a type of chest pain caused by reduced blood flow to the heart. Unlike other angina medications, Ranexa works in a unique way to improve heart function and reduce symptoms.

How exactly does Ranexa work? Ranolazine is believed to enhance the heart’s efficiency in using oxygen, allowing it to perform more work with less oxygen demand. This mechanism of action differs from traditional angina treatments like nitrates or beta-blockers, which primarily focus on dilating blood vessels or reducing heart rate.

Can Ranexa be used alongside other angina medications? Yes, due to its distinct mechanism of action, Ranexa can be safely combined with other angina treatments such as nitrates, calcium channel blockers (e.g., amlodipine), and beta-blockers (e.g., metoprolol). This versatility makes it a valuable addition to existing angina management strategies.

Proper Usage and Dosage Guidelines for Ranexa

Taking Ranexa correctly is crucial for achieving optimal therapeutic benefits. Here are the key points to remember about proper usage and dosage:

• Ranexa is typically taken orally twice daily, with or without food.
• The tablets should be swallowed whole – never crush, chew, or split them.
• Dosage is determined by your doctor based on individual factors such as medical condition, response to treatment, and other medications you may be taking.
• It’s important to use Ranexa regularly as prescribed to maximize its benefits.

Is there anything to avoid while taking Ranexa? Yes, it’s advisable to avoid consuming grapefruit or grapefruit juice while using this medication, as it can increase the risk of side effects. Always consult your healthcare provider about potential food interactions.

Potential Side Effects and Risks Associated with Ranexa

While Ranexa can be an effective treatment for chronic angina, it’s important to be aware of potential side effects. Common side effects may include:

• Dizziness
• Headache
• Constipation
• Nausea

Are there any serious side effects to watch out for? Yes, although rare, more severe side effects can occur. These may include:

• Irregular heartbeat
• Fainting
• Severe dizziness

If you experience any of these serious side effects, it’s crucial to seek medical attention immediately.

Drug Interactions: What to Know When Taking Ranexa

Ranexa can interact with numerous other medications, potentially altering their effectiveness or increasing the risk of side effects. According to the Drugs.com interaction checker, there are 510 known drug interactions with Ranexa, categorized as follows:

• 161 major interactions
• 318 moderate interactions
• 31 minor interactions

Which medications are most likely to interact with Ranexa? Some commonly prescribed medications that may interact with Ranexa include:

1. Amlodipine
2. Aspirin
3. Atorvastatin
4. Clopidogrel
5. Metoprolol
6. Simvastatin

It’s crucial to inform your healthcare provider about all medications you’re taking, including over-the-counter drugs and herbal supplements, to avoid potential harmful interactions.

Precautions and Contraindications for Ranexa Use

While Ranexa can be beneficial for many patients with chronic angina, certain individuals should exercise caution or avoid its use altogether. Key precautions include:

• Liver function: Patients with severe liver impairment should not use Ranexa.
• QT prolongation: Ranexa may affect heart rhythm, particularly in individuals with a history of QT prolongation.
• Kidney disease: Patients with renal impairment may require dose adjustments.

Are there any specific groups who should avoid Ranexa? Yes, Ranexa is generally not recommended for:

• Pregnant or breastfeeding women (due to limited safety data)
• Patients taking certain medications that strongly interact with Ranexa
• Individuals with severe liver disease

Ranexa in Combination Therapy: Enhancing Angina Management

One of the advantages of Ranexa is its ability to be used in combination with other angina medications. This versatility allows for a more comprehensive approach to managing chronic angina. Some common combination therapies include:

• Ranexa + nitrates (e.g., nitroglycerin)
• Ranexa + beta-blockers (e.g., metoprolol)
• Ranexa + calcium channel blockers (e.g., amlodipine)

How does combination therapy benefit patients? By addressing multiple aspects of angina pathophysiology, combination therapy can often provide more effective symptom relief and improved quality of life for patients with chronic angina.

Monitoring and Follow-up: Ensuring Safe and Effective Ranexa Use

Regular monitoring is essential when using Ranexa to ensure its effectiveness and detect any potential issues early. Key aspects of monitoring include:

• Periodic ECG measurements to check for QT prolongation
• Liver function tests, especially in patients with a history of liver problems
• Assessment of kidney function, particularly in older adults or those with known renal issues
• Regular evaluation of angina symptoms and overall cardiovascular health

How often should follow-up appointments be scheduled? The frequency of follow-up visits will depend on individual patient factors, but typically, patients should have regular check-ups every 3-6 months, or more frequently if adjustments to the treatment plan are needed.

Understanding QT Prolongation Risk with Ranexa

QT prolongation is a potential concern with Ranexa use, as it can increase the risk of dangerous heart rhythm disturbances. Patients should be aware of the following:

• Ranexa can cause a small increase in the QT interval on ECG
• The risk is higher in patients with pre-existing QT prolongation or those taking other medications that affect the QT interval
• Regular ECG monitoring is important, especially when starting Ranexa or adjusting the dose

What symptoms might indicate a problem with QT prolongation? Patients should be alert for signs such as irregular heartbeat, dizziness, or fainting, and report these to their healthcare provider immediately.

Long-term Considerations for Ranexa Users

For patients using Ranexa as a long-term treatment for chronic angina, several factors should be considered:

• Consistent use: Ranexa is most effective when taken regularly as prescribed
• Lifestyle modifications: Combining Ranexa with heart-healthy lifestyle changes can enhance overall cardiovascular health
• Regular check-ups: Ongoing monitoring of heart function and medication effectiveness is crucial
• Potential for dose adjustments: Over time, your doctor may need to adjust your Ranexa dosage based on your response and any changes in your overall health

Can Ranexa be safely used indefinitely? While Ranexa can be used long-term for chronic angina management, ongoing evaluation of its benefits and risks is important. Your healthcare provider will assess the continued need for Ranexa as part of your overall treatment plan.

Managing Side Effects of Long-term Ranexa Use

While Ranexa is generally well-tolerated, some patients may experience side effects with long-term use. Strategies for managing common side effects include:

• Dizziness: Rise slowly from sitting or lying positions, and avoid activities requiring full alertness until you know how Ranexa affects you
• Constipation: Increase fiber intake, stay hydrated, and consider gentle laxatives if needed (consult your doctor first)
• Headache: Over-the-counter pain relievers may help, but check with your doctor to ensure they don’t interact with Ranexa

When should you report side effects to your doctor? Any persistent or worsening side effects should be discussed with your healthcare provider, as they may necessitate adjustments to your treatment plan.

Ranexa and Lifestyle: Optimizing Treatment Outcomes

While Ranexa can significantly improve angina symptoms, combining medication with heart-healthy lifestyle choices can enhance overall cardiovascular health. Key lifestyle considerations for Ranexa users include:

• Regular exercise: Engage in physician-approved physical activities to improve heart health
• Balanced diet: Focus on heart-healthy foods low in saturated fats and rich in fruits, vegetables, and whole grains
• Stress management: Practice stress-reduction techniques like meditation or yoga
• Smoking cessation: If you smoke, work with your healthcare provider on a plan to quit
• Alcohol moderation: Limit alcohol intake as advised by your doctor

How can lifestyle changes complement Ranexa treatment? By adopting heart-healthy habits, you can potentially reduce the frequency and severity of angina episodes, improve your overall cardiovascular health, and enhance the effectiveness of your Ranexa treatment.

Exercise Considerations for Ranexa Users

Exercise is an important component of heart health, but patients taking Ranexa should approach physical activity with caution:

• Start slowly and gradually increase intensity and duration of exercise
• Be aware of your physical limits and stop if you experience chest pain or severe shortness of breath
• Consult your doctor about appropriate exercise types and intensity levels for your condition
• Consider cardiac rehabilitation programs for supervised exercise and education

Is it safe to exercise while taking Ranexa? In most cases, yes. However, it’s crucial to work closely with your healthcare provider to develop an exercise plan that’s safe and appropriate for your individual health status and treatment regimen.

Understanding Ranexa’s Place in Comprehensive Angina Management

Ranexa represents an important advancement in the treatment of chronic angina, offering a unique mechanism of action that complements traditional therapies. Key points to remember about Ranexa’s role in angina management include:

• Adjunct therapy: Ranexa is often used in combination with other angina medications for enhanced symptom control
• Improved exercise tolerance: Many patients report increased ability to perform daily activities with less angina
• Quality of life impact: By reducing angina frequency and severity, Ranexa can significantly improve patients’ quality of life
• Individualized approach: The decision to use Ranexa should be based on a comprehensive evaluation of each patient’s specific needs and risk factors

How does Ranexa compare to other angina treatments? While direct comparisons are complex, Ranexa’s unique mechanism of action and ability to be used in combination with other treatments make it a valuable option, particularly for patients who have inadequate response to standard therapies.

Future Directions in Ranexa Research

Ongoing research continues to explore the potential applications and benefits of Ranexa beyond its current use in chronic angina. Areas of investigation include:

• Potential use in acute coronary syndromes
• Effects on arrhythmias and heart failure
• Long-term cardiovascular outcomes in Ranexa users
• Combination therapies with newer antianginal agents

What potential future developments might we see with Ranexa? While it’s important to rely on current approved indications, ongoing research may expand our understanding of Ranexa’s benefits and potentially lead to new therapeutic applications in cardiovascular medicine.

Ranexa Interactions Checker – Drugs.com

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There are 510 drugs known to interact with
Ranexa (ranolazine), along with
3 disease interactions, and 1 alcohol/food interaction.

Of the total drug interactions,
161 are major, 318 are moderate, and 31 are minor.

Does Ranexa interact with my other drugs?

Enter other medications to view a detailed report.

• View all 510 medications that may interact with Ranexa
• View Ranexa alcohol/food interactions (1)
• View Ranexa disease interactions (3)

Most frequently checked interactions

View interaction reports for Ranexa (ranolazine) and the medicines listed below.

• Major
• Moderate
• Minor
• Unknown

• amlodipine
• Aspir 81 (aspirin)
• aspirin
• Aspirin Low Strength (aspirin)
• atorvastatin
• carvedilol
• clopidogrel
• Crestor (rosuvastatin)
• furosemide
• gabapentin
• Imdur (isosorbide mononitrate)
• isosorbide mononitrate
• Lasix (furosemide)
• levothyroxine
• Lipitor (atorvastatin)
• lisinopril
• losartan
• metformin
• metoprolol
• Metoprolol Succinate ER (metoprolol)
• Metoprolol Tartrate (metoprolol)
• nitroglycerin
• Nitrostat (nitroglycerin)
• omeprazole
• pantoprazole
• Plavix (clopidogrel)
• potassium chloride
• simvastatin
• Vitamin B12 (cyanocobalamin)
• Vitamin D3 (cholecalciferol)

Ranexa alcohol/food interactions

There is 1 alcohol/food interaction with Ranexa (ranolazine).

Ranexa disease interactions

There are 3 disease interactions with Ranexa (ranolazine) which include:

• severe hepatic impairment
• QT prolongation
• renal disease

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More about Ranexa (ranolazine)

• Ranexa consumer information
• Compare alternatives
• Pricing & coupons
• Reviews (67)
• Drug images
• Side effects
• Dosage information
• During pregnancy
• FDA approval history
• Drug class: antianginal agents
• En español

Related treatment guides

• Angina

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Ranexa Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Ranolazine is used to treat a certain type of chest pain (chronic angina). It decreases how often you may get chest pain and may help to increase your ability to exercise.Ranolazine works differently than other drugs for angina, so it can be used with your other angina medications (including nitrates, calcium channel blockers such as amlodipine, beta blockers such as metoprolol). It is thought to work by improving how well the heart uses oxygen so that it can do more work with less oxygen.

How to use Ranexa

Read the Patient Information Leaflet if available from your pharmacist before you start taking ranolazine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually twice daily. Swallow this medication whole. Do not crush, chew, or split tablets. Doing so can release all of the drug at once, increasing the risk of side effects.

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Do not take more of this medication than your doctor prescribes.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. This medication must be taken regularly to be effective. It should not be used to treat angina when it occurs. Use other medications (such as sublingual nitroglycerin) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Tell your doctor if your condition does not get better or if it gets worse (such as if your chest pain happens more often).

Side Effects

Dizziness, headache, lightheadedness, nausea, tiredness, and constipation may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine).

Get medical help right away if you have any very serious side effects, including: fainting, severe dizziness, fast/irregular heartbeat.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking ranolazine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems (such as cirrhosis), kidney problems.

Ranolazine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

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

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using ranolazine safely.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Other medications can affect the removal of ranolazine from your body, which may affect how ranolazine works. Examples include azole antifungals (such as itraconazole, ketoconazole), clarithromycin, cobicistat, nefazodone, HIV protease inhibitors (such as indinavir, nelfinavir, saquinavir), rifamycins (such as rifabutin, rifampin), ritonavir, drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin), St. John’s wort, among others.

Does Ranexa interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness/fainting, fast/irregular/very slow heartbeat, mental/mood changes (such as confusion, hallucinations), vomiting, severe tremor, unsteadiness.

Do not share this medication with others.

Lab and/or medical tests (such as kidney function) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Ranexa 1,000 mg tablet,extended release

Color: pale yellowShape: oblongImprint: GSI1000

This medicine is a pale yellow, oblong, film-coated, tablet imprinted with “GSI1000”.

Ranexa 500 mg tablet,extended release

Color: light orangeShape: oblongImprint: GSI500

This medicine is a pale yellow, oblong, film-coated, tablet imprinted with “GSI1000”.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Ranex – a new milestone in the treatment of stable angina | #08/13

By selectively inhibiting the late sodium current, ranolazine prevents the overload of cardiomyocytes with sodium ions, blocking the reverse sodium-calcium exchange and the accumulation of calcium ions. Can be used as monotherapy and in combination

#08/13

Keywords / keywords:

Ranolazine, Stable stenocardia

Ranexa: a new step in treatment of stable stenocardia

Through selective inhibit ion of late sodium current, ranolazine prevents cardiomyocites overloading by sodium ions, blocking reverse sodium-calcium exchange and accumulation of calcium ions. It can be applied as a single-drug therapy amounting to combined treatment of stable stenocardia.

As advertising

Modern medicine offers a wide range of tools used to treat coronary heart disease, including both drug therapy and invasive treatments. But, despite all the achievements of medicine, a significant part of patients suffering from coronary heart disease continues to experience symptoms of angina pectoris, which significantly limits their activity and reduces the quality of everyday life.

For these reasons, at the present stage, one of the main tasks in the treatment of patients with stable angina is still to reduce the frequency and intensity of angina attacks in order to improve the patient’s quality of life.

Berlin-Chemie/A Menarini introduces a new drug in its cardiology line – Ranexa®. Ranexa® is an innovative drug for the treatment of stable angina pectoris.

Ranexa® was first registered in the United States in 2006, where it was approved by the Food and Drug Administration of the United States (FDA) as a drug for the treatment of stable angina pectoris. The drug has been on the European market since 2008.

Ranexa® is a new drug for the treatment of stable angina with an innovative mechanism of action that reduces ischemia in patients with stable angina.

The clinical manifestations of stable angina are based on transient myocardial ischemia, which is caused by a mismatch between myocardial oxygen demand and its delivery. Under conditions of ischemia, cardiomyocytes are overloaded with calcium ions, which in turn leads to impaired myocardial relaxation during diastole and impaired diastolic filling of the coronary arteries, provoking an angina attack.

Ranolazine, the active ingredient of the original drug Ranexa®, is a powerful inhibitor of late sodium current. By selectively inhibiting the late sodium current, ranolazine prevents the overload of cardiomyocytes with sodium ions, thereby blocking the reverse sodium-calcium metabolism and, accordingly, the accumulation of calcium ions in the cell. This contributes to the improvement of the mechanical and electrical function of the myocardium by improving diastolic relaxation and coronary blood flow without affecting the hemodynamic parameters and independently of them. Due to this mechanism of action, the drug breaks the vicious circle of ischemia, restoring the balance between the delivery and consumption of oxygen by the myocardium.

The mechanism of action of ranolazine is unique and fundamentally new, which distinguishes it from other classes of drugs for the treatment of stable angina pectoris and suggests the emergence of a new modern class of antianginal drugs.

The high efficacy and safety parameters of ranolazine have been studied in large multicenter clinical trials (MARISA, CARISA, ROLE, ERICA, MERLIN-TIMI, TERISA), which involved more than 8,000 patients. Ranolazine has an effective antianginal and antiischemic effect, has been proven to reduce the frequency of angina attacks and increase exercise tolerance in patients with stable angina pectoris.

The drug is included in European and American guidelines for the diagnosis and treatment of stable angina.

Ranexa® is available in two dosages of 500 mg and 100 mg.