What are the primary uses of Ranexa. How should Ranexa be taken for optimal effectiveness. What are the potential side effects of Ranexa. How does Ranexa interact with other medications. What precautions should be taken when using Ranexa.

Understanding Ranexa: A Unique Antianginal Medication

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 antianginal drugs, Ranexa works through a unique mechanism that improves the heart’s oxygen utilization, allowing it to function more efficiently with less oxygen demand.

What sets Ranexa apart from other angina medications? Ranexa doesn’t directly affect heart rate or blood pressure. Instead, it modulates sodium and calcium levels in heart cells, which helps reduce the oxygen demand of the heart muscle. This distinctive action allows Ranexa to be used in combination with other angina treatments, providing an additional layer of symptom management for patients with chronic stable angina.

Indications and Uses of Ranexa

The primary use of Ranexa is for the treatment of chronic angina. However, its applications extend beyond this primary indication. Let’s explore the various uses of this medication:

• Chronic stable angina: Ranexa is FDA-approved for this condition, particularly in patients who haven’t responded adequately to other antianginal drugs.
• Complementary therapy: It can be used alongside other angina medications such as nitrates, calcium channel blockers, and beta-blockers.
• Exercise tolerance: Ranexa may help increase a patient’s ability to exercise by reducing the frequency of angina attacks.
• Potential off-label uses: Some studies suggest Ranexa might be beneficial in certain arrhythmias and diabetes, though more research is needed in these areas.

How effective is Ranexa in managing chronic angina? Clinical trials have shown that Ranexa can significantly reduce the frequency of angina attacks and increase exercise duration in patients with chronic stable angina. In one study, patients taking Ranexa experienced a 20% reduction in weekly angina episodes compared to those on placebo.

Proper Dosage and Administration of Ranexa

Administering Ranexa correctly is crucial for its effectiveness and safety. Here’s what you need to know about the dosage and administration of this medication:

• Standard dosage: The typical starting dose is 500 mg twice daily, which may be increased to 1000 mg twice daily as needed.
• Extended-release formulation: Ranexa is available as extended-release tablets, which should be swallowed whole and not crushed, chewed, or split.
• Timing: It can be taken with or without food.
• Consistency: Regular use is important for maximum benefit.
• Dose adjustments: May be necessary for patients with kidney or liver problems.

What should you do if you miss a dose of Ranexa? If you forget to take a dose, take it as soon as you remember. However, if it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Never take a double dose to make up for a missed one.

Special Considerations for Ranexa Dosing

Certain factors may influence the dosing of Ranexa:

1. Renal impairment: Patients with moderate to severe kidney disease may require lower doses.
2. Hepatic impairment: Use is contraindicated in patients with severe liver disease.
3. Drug interactions: Dose adjustments may be necessary when used with certain medications that affect its metabolism.
4. Elderly patients: No specific dose adjustments are typically needed based on age alone, but caution is advised due to the higher likelihood of decreased kidney function in older adults.

Potential Side Effects and Adverse Reactions

Like all medications, Ranexa can cause side effects. While not everyone experiences them, it’s important to be aware of potential adverse reactions:

• Common side effects: Dizziness, headache, constipation, nausea
• Less common side effects: Weakness, fatigue, vertigo, dry mouth
• Rare but serious side effects: QT prolongation (a heart rhythm disorder), kidney problems, severe allergic reactions

What should you do if you experience side effects from Ranexa? If you notice any severe or persistent side effects, contact your healthcare provider immediately. For mild side effects, they often resolve as your body adjusts to the medication. However, if they persist or worsen, consult your doctor.

Managing Side Effects of Ranexa

While side effects can be concerning, there are strategies to manage them:

1. Dizziness: Rise slowly from sitting or lying positions, especially when starting the medication.
2. Constipation: Increase fiber intake, stay hydrated, and exercise regularly.
3. Nausea: Take Ranexa with food if nausea occurs when taken on an empty stomach.
4. Headache: Over-the-counter pain relievers may help, but consult your doctor first.

Drug Interactions and Precautions

Ranexa can interact with numerous medications, potentially altering its effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for safe use:

• Major interactions: Certain antifungals (e.g., ketoconazole), some antibiotics (e.g., clarithromycin), and HIV protease inhibitors
• Moderate interactions: Many common medications including statins, some antidepressants, and certain blood pressure medications
• Minor interactions: Include some over-the-counter medications and supplements

How can you minimize the risk of drug interactions with Ranexa? Always inform your healthcare provider about all medications, supplements, and herbal products you’re taking. Your doctor may need to adjust dosages or monitor you more closely if you must take Ranexa with interacting drugs.

Important Precautions When Using Ranexa

Several precautions should be considered when using Ranexa:

1. Liver function: Ranexa is contraindicated in severe liver impairment and should be used cautiously in mild to moderate liver disease.
2. Kidney function: Dose adjustments may be necessary for patients with kidney problems.
3. QT prolongation: Ranexa can affect heart rhythm, so it should be used cautiously in patients at risk for QT prolongation.
4. Pregnancy and breastfeeding: The safety of Ranexa during pregnancy or breastfeeding hasn’t been established, so it should only be used if the potential benefit outweighs the risk.

Ranexa in Special Populations

The use of Ranexa may require special considerations in certain groups of patients:

• Elderly patients: No specific dose adjustments are typically needed, but caution is advised due to the higher likelihood of decreased kidney function.
• Pediatric patients: The safety and effectiveness of Ranexa in children have not been established.
• Patients with comorbidities: Those with diabetes, heart failure, or other cardiovascular conditions may require closer monitoring.

How does age affect the efficacy and safety of Ranexa? While age itself doesn’t significantly impact Ranexa’s effectiveness, older adults may be more susceptible to side effects due to age-related changes in kidney and liver function. Close monitoring is important in this population.

Monitoring and Follow-up While on Ranexa

Regular monitoring is essential when taking Ranexa to ensure its effectiveness and detect any potential issues early:

• Efficacy monitoring: Your doctor will assess the frequency and severity of your angina symptoms.
• ECG monitoring: Periodic electrocardiograms may be performed to check for QT prolongation.
• Kidney and liver function tests: These may be done periodically, especially in patients with pre-existing kidney or liver issues.
• Blood tests: To check for any changes in electrolyte levels or other metabolic parameters.

What should you discuss with your doctor during follow-up appointments? Be prepared to talk about any changes in your symptoms, side effects you’ve experienced, and any new medications or supplements you’ve started. This information helps your healthcare provider optimize your treatment plan.

Long-term Use of Ranexa

For many patients, Ranexa is a long-term medication. Here are some considerations for extended use:

1. Continued efficacy: Ranexa generally maintains its effectiveness over time without developing tolerance.
2. Adherence: Consistent use is important for optimal benefit.
3. Regular check-ups: Periodic evaluations help ensure the medication continues to be appropriate and effective.
4. Lifestyle modifications: Combining Ranexa with heart-healthy lifestyle changes can enhance overall cardiovascular health.

Patient Education and Self-Management with Ranexa

Empowering patients with knowledge about Ranexa can improve treatment outcomes. Here are key points for patient education:

• Proper administration: Take Ranexa as prescribed, swallowing tablets whole.
• Consistency: Maintain a regular dosing schedule for optimal effect.
• Monitoring: Be aware of potential side effects and report any concerns to your healthcare provider.
• Interactions: Inform all healthcare providers about Ranexa use to avoid potential drug interactions.
• Lifestyle: Combine medication with heart-healthy habits for best results.

How can patients actively participate in their treatment with Ranexa? Keeping a symptom diary can be helpful. Track the frequency and severity of angina episodes, noting any patterns or triggers. This information can be valuable for your healthcare provider in assessing the medication’s effectiveness and making any necessary adjustments to your treatment plan.

Complementary Strategies for Angina Management

While Ranexa is an effective medication for chronic angina, combining it with other strategies can enhance overall heart health:

1. Regular exercise: Gradually increase physical activity as tolerated, under medical supervision.
2. Heart-healthy diet: Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins.
3. Stress management: Practice relaxation techniques like deep breathing or meditation.
4. Smoking cessation: If you smoke, quitting is one of the most important steps for heart health.
5. Weight management: Maintain a healthy weight to reduce stress on your heart.

Ranexa represents a significant advancement in the treatment of chronic stable angina, offering a unique mechanism of action that complements traditional therapies. Its ability to improve the heart’s oxygen utilization without significantly affecting heart rate or blood pressure makes it a valuable option for many patients. However, like all medications, it requires careful management and regular monitoring to ensure safe and effective use. By understanding the proper use, potential side effects, and important precautions associated with Ranexa, patients and healthcare providers can work together to optimize its benefits in managing chronic angina and improving 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.