What is Ranexa used for. How should Ranexa be taken. What are the potential side effects of Ranexa. How does Ranexa interact with other medications. Who should not take Ranexa. What precautions should be taken when using Ranexa. How effective is Ranexa for treating chronic angina.

Understanding Ranexa: A Comprehensive Guide to Its Uses and Benefits

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 traditional angina medications, Ranexa works differently, making it a valuable addition to existing treatment regimens. But what exactly is Ranexa, and how does it help manage chronic angina?

Ranexa is classified as an antianginal agent, designed to improve the heart’s efficiency in using oxygen. By enhancing the heart’s ability to function with less oxygen, Ranexa can help reduce the frequency of angina attacks and increase a patient’s exercise capacity. This unique mechanism of action sets it apart from other angina medications, allowing it to be used in combination with standard treatments like nitrates, calcium channel blockers, and beta-blockers.

Key Benefits of Ranexa

• Reduces frequency of angina attacks
• Improves exercise tolerance
• Can be used alongside other angina medications
• Does not significantly affect heart rate or blood pressure

Is Ranexa suitable for all types of angina? While Ranexa is specifically approved for chronic angina, it’s not typically used as a first-line treatment. It’s often prescribed when other medications haven’t provided sufficient relief or when patients can’t tolerate the side effects of traditional angina drugs.

Proper Usage and Dosage Guidelines for Ranexa

Administering Ranexa correctly is crucial for achieving optimal results and minimizing potential side effects. How should patients take this medication to ensure its effectiveness?

Ranexa is available as extended-release tablets and should be taken orally, with or without food, typically twice daily. It’s important to swallow the tablets whole without crushing, chewing, or splitting them, as this can release the entire dose at once, increasing the risk of side effects.

Typical Dosage Schedule

1. Starting dose: 500 mg twice daily
2. Dose may be increased to 1000 mg twice daily after 2-4 weeks, based on clinical response
3. Maximum recommended dose: 1000 mg twice daily

Can the dosage of Ranexa be adjusted? Yes, your healthcare provider may adjust your dosage based on your individual response to the medication, kidney function, and other factors. It’s crucial to follow your doctor’s instructions precisely and not to change your dose without consulting them first.

Potential Side Effects and Safety Considerations of Ranexa

While Ranexa can be an effective treatment for chronic angina, it’s important to be aware of potential side effects and safety considerations. What are the most common side effects patients might experience when taking Ranexa?

Common side effects of Ranexa include:

• Dizziness
• Headache
• Constipation
• Nausea
• Weakness

Most of these side effects are mild and tend to diminish over time as the body adjusts to the medication. However, there are some more serious side effects that require immediate medical attention.

Serious Side Effects to Watch For

• QT prolongation (a heart rhythm problem)
• Kidney problems
• Severe dizziness or fainting
• Unusual changes in heart rhythm

Are there any specific groups who should avoid taking Ranexa? Yes, certain individuals should not use Ranexa or should use it with caution. These include people with severe liver problems, those taking certain medications that interact with Ranexa, and individuals with a history of certain heart rhythm disorders.

Drug Interactions: What to Know When Taking Ranexa

Ranexa can interact with numerous other medications, potentially altering its effectiveness or increasing the risk of side effects. How many drug interactions are known for Ranexa, and which are the most significant?

According to the Drugs.com interaction checker, Ranexa has 510 known drug interactions. Of these:

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

Additionally, there are 3 disease interactions and 1 alcohol/food interaction to consider. Given the extensive list of potential interactions, it’s crucial for patients to inform their healthcare providers about all medications, supplements, and herbal products they’re taking.

Common Medications That Interact with Ranexa

• Certain antibiotics (e.g., clarithromycin, erythromycin)
• Antifungal medications (e.g., ketoconazole, itraconazole)
• Some HIV medications
• Certain heart rhythm medications
• Some antidepressants

Why is it important to avoid grapefruit while taking Ranexa? Grapefruit and grapefruit juice can increase the levels of Ranexa in your blood, potentially leading to an increased risk of side effects. It’s best to avoid grapefruit products unless your healthcare provider specifically says it’s safe to consume them.

Ranexa and Cardiovascular Health: Beyond Angina Management

While Ranexa is primarily used for chronic angina, research has suggested it may have additional benefits for cardiovascular health. What other potential applications are being explored for this medication?

Some studies have indicated that Ranexa may have positive effects on:

• Blood glucose control in diabetic patients
• Reduction of arrhythmias, particularly atrial fibrillation
• Improvement of symptoms in patients with microvascular angina

These potential benefits are still being researched and are not currently approved indications for Ranexa. However, they highlight the complex and multifaceted nature of this medication’s effects on the cardiovascular system.

Ranexa and Diabetes

How might Ranexa benefit patients with diabetes? Some studies have shown that Ranexa can help lower HbA1c levels in diabetic patients with chronic angina. This dual effect on both angina and blood glucose control could make Ranexa particularly beneficial for patients dealing with both conditions. However, more research is needed to fully understand this relationship and its clinical implications.

Precautions and Special Considerations for Ranexa Use

While Ranexa can be an effective treatment for chronic angina, there are several precautions and special considerations that patients and healthcare providers should be aware of. What are some key factors to consider when using Ranexa?

Liver and Kidney Function

Ranexa is metabolized by the liver and excreted by the kidneys. Patients with moderate to severe liver impairment or kidney disease may require dose adjustments or may not be suitable candidates for Ranexa therapy. Regular monitoring of liver and kidney function may be necessary for patients on this medication.

QT Prolongation

Ranexa can cause QT prolongation, a change in the heart’s electrical activity that can potentially lead to serious rhythm problems. Patients with a history of QT prolongation or those taking other medications that can affect the QT interval should be closely monitored.

Pregnancy and Breastfeeding

The safety of Ranexa during pregnancy and breastfeeding has not been established. Women who are pregnant, planning to become pregnant, or breastfeeding should discuss the potential risks and benefits with their healthcare provider before using Ranexa.

Are there any specific tests required before starting Ranexa? Before initiating Ranexa therapy, your doctor may order tests to check your liver and kidney function, as well as an ECG to assess your heart’s electrical activity. These tests help ensure that Ranexa is safe and appropriate for you to use.

Comparing Ranexa to Other Angina Treatments

Ranexa is one of several medications available for managing chronic angina. How does it compare to other common treatments in terms of efficacy and side effect profile?

Unlike traditional angina medications such as beta-blockers, calcium channel blockers, and nitrates, Ranexa does not significantly affect heart rate or blood pressure. This can make it a suitable option for patients who cannot tolerate the hemodynamic effects of these other medications.

Ranexa vs. Beta-Blockers

• Beta-blockers reduce heart rate and blood pressure, which can cause fatigue and dizziness
• Ranexa does not typically cause these side effects
• Beta-blockers may be more effective for some patients, particularly those with hypertension

Ranexa vs. Calcium Channel Blockers

• Calcium channel blockers can cause edema (swelling) and constipation
• Ranexa is less likely to cause edema but can still cause constipation
• Both can be effective for angina relief

Ranexa vs. Nitrates

• Nitrates provide rapid relief of angina symptoms
• Ranexa is used for ongoing management rather than acute symptom relief
• Nitrates can cause headaches and low blood pressure, which are less common with Ranexa

Which angina treatment is most effective? The effectiveness of angina treatments can vary from person to person. Some patients may find the best relief with a combination of different medications, including Ranexa. Your healthcare provider will work with you to determine the most appropriate treatment plan based on your individual needs and medical history.

Long-Term Use of Ranexa: What Patients Should Know

For many patients with chronic angina, Ranexa may be prescribed for long-term use. What should patients be aware of when taking this medication over an extended period?

Long-term use of Ranexa has generally been found to be safe and effective in clinical studies. However, as with any long-term medication use, there are some important considerations:

Regular Monitoring

Patients on long-term Ranexa therapy should have regular check-ups with their healthcare provider. These visits may include:

• Assessment of angina symptoms and overall heart health
• Blood tests to monitor liver and kidney function
• ECG to check for any changes in heart rhythm
• Review of any side effects or concerns

Consistent Use

Ranexa is most effective when taken consistently as prescribed. Patients should not stop taking Ranexa suddenly without consulting their doctor, as this could lead to a worsening of angina symptoms.

Lifestyle Factors

While Ranexa can help manage angina symptoms, it’s important for patients to maintain heart-healthy lifestyle habits, including:

• Regular exercise (as approved by your doctor)
• Healthy diet
• Stress management
• Smoking cessation (if applicable)

Can patients develop tolerance to Ranexa over time? Unlike some medications, there’s no evidence to suggest that patients develop tolerance to Ranexa with long-term use. However, if you feel that the medication is becoming less effective over time, it’s important to discuss this with your healthcare provider, as it could indicate a progression of your underlying heart condition.

In conclusion, Ranexa represents an important treatment option for patients with chronic angina, particularly those who haven’t found sufficient relief with traditional therapies. Its unique mechanism of action and favorable side effect profile make it a valuable tool in the management of this challenging condition. However, as with any medication, it’s crucial for patients to work closely with their healthcare providers to ensure safe and effective use, particularly in the context of potential drug interactions and individual health considerations. By understanding the benefits, risks, and proper use of Ranexa, patients can take an active role in managing their angina and improving their overall quality of life.

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.