Generic name: ranolazine (ra NOE la zeen)
Brand name: Ranexa
Drug class: Antianginal agents
Ranexa (ranolazine) is used to treat chronic angina (chest pain). It works by improving blood flow to help the heart work more efficiently.
Ranexa is not for use during an acute (emergency) attack of angina.
Ranexa may also be used for purposes not listed in this medication guide.
Warnings
You should not take Ranexa if you have cirrhosis of the liver.
Serious drug interactions can occur when certain medicines are used together with ranolazine. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.
Ranexa is not for use during an acute (emergency) attack of chest pain. Continue using any other medicines prescribed by your doctor (such as nitroglycerin) to treat acute chest pain.
Before you take Ranexa, tell your doctor about all of your medical conditions, especially if you have a personal or family history of Long QT syndrome.
Chronic angina is often treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.
Before taking this medicine
You should not take Ranexa if you are allergic to ranolazine, or if you have cirrhosis of the liver.
Many other drugs can interact with ranolazine and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:
- clarithromycin;
- nefazodone;
- St. John's wort;
- antifungal medicine - itraconazole, ketoconazole;
- HIV or AIDS medicine - indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir;
- tuberculosis medicine - rifabutin, rifampin, rifapentine; or
- seizure medicine-carbamazepine, phenobarbital, phenytoin.
To make sure Ranexa is safe for you, tell your doctor if you have:
- a heart rhythm disorder;
- liver disease;
- kidney disease; or
- a personal or family history of long QT syndrome.
It is not known whether Ranexa will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
It is not known whether ranolazine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I take Ranexa?
Take Ranexa exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Ranexa may be taken with or without food.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
Call your doctor if your symptoms do not improve, or if they get worse while using Ranexa.
Chronic angina is often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.
Store Ranexa at room temperature away from moisture and heat.
Dosing information
Usual Adult Dose of Ranexa for Angina (Chest Pain):
The typical starting dose is: 500 mg orally twice daily. If needed, your doctor may increase to 1000 mg orally twice daily.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose can cause nausea, vomiting, numbness or tingling, dizziness, double vision, confusion, or fainting.
What to avoid
Ranexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Grapefruit and grapefruit juice may interact with Ranexa and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.
Ranexa side effects
Get emergency medical help if you have any signs of an allergic reaction to Ranexa: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a light-headed feeling, like you might pass out;
- headache with chest pain and severe dizziness, fast or pounding heartbeats; or
- kidney problems - little or no urination; painful or difficult urination, swelling in your feet or ankles; feeling tired or short of breath.
Common Ranexa side effects may include:
- nausea, constipation;
- headache; or
- dizziness.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Ranexa?
The following drugs can interact with ranolazine and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:
- clarithromycin;
- nefazodone;
- St. John's wort;
- antifungal medicine - itraconazole, ketoconazole;
- HIV or AIDS medicine - indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir;
- tuberculosis medicine - rifabutin, rifampin, rifapentine; or
- seizure medicine-carbamazepine, phenobarbital, phenytoin.
Many other drugs can interact with Ranexa. Below is just a partial list. Tell your doctor if you are using:
- aprepitant (Emend);
- arsenic trioxide (Trisenox);
- chloroquine (Aralen);
- digoxin (Lanoxin);
- fluconazole (Diflucan);
- lovastatin (Mevacor, Altoprev, Advicor), simvastatin (Zocor, Simcor, Vytorin);
- tamsulosin (Flomax);
- tolterodine (Detrol);
- ADHD medication such as atomoxetine (Strattera), dextroamphetamine (Adderall), methamphetamine (Desoxyn), methylphenidate (Ritalin, Daytrana, Metadate, Concerta);
- an antibiotic such as azithromycin (Zithromax), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), pentamidine (NebuPent, Pentam);
- an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), duloxetine (Cymbalta), fluoxetine (Prozac, Sarafem, Symbyax), imipramine (Tofranil), mirtazepine (Remeron), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), venlafaxine (Effexor), and others;
- cancer medicine such as doxorubicin (Adriamycin, Doxil), lomustine (CeeNU), tamoxifen (Soltamox);
- cough medicine such as dextromethorphan (Delsym, Robitussin Maximum Strength, Vicks 44, and others) or dihydrocodeine (Alahist DHC, J-Max DHC, Pancof-PD, Panlor, Trezix, Welltuss EXP, and others);
- heart or blood pressure medicine such as amiodarone (Cordarone, Pacerone), betaxolol (Kerlone), captopril (Capoten), carvedilol (Coreg), diltiazem (Cartia, Cardizem), dofetilide (Tikosyn), disopyramide (Norpace), dronedarone (Multaq), flecainide (Tambocor), ibutilide (Corvert), labetalol (Normodyne), metoprolol (Dutoprol, Lopressor, Toprol), mexilitene (Mexitil), nicardipine (Cardene), quinidine (Quin-G), pindolol (Visken), procainamide (Procan, Pronestyl), propafenone (Rythmol), propranolol (Inderal, InnoPran), sotalol (Betapace, Sorine), timolol (Blocadren), or verapamil (Calan, Covera, Isoptin);
- medicine to prevent or treat nausea and vomiting such as dolasetron (Anzemet), droperidol (Inapsine), or ondansetron (Zofran);
- medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), fluphenazine (Permitil), haloperidol (Haldol), pimozide (Orap), promethazine (Phenergan), perphenazine (Trilafon), risperidone (Risperdal), thioridazine (Mellaril), or ziprasidone (Geodon);
- medicine used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf);
- migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);
- narcotic medication such as methadone (Methadose, Diskets, Dolophine); or
- pain medication such as codeine (Tylenol #3), hydrocodone (Lortab, Vicodin, Vicoprofen), oxycodone (OxyContin, Percocet), or tramadol (Ultram, Ultracet).
This list is not complete and here are many other drugs that can interact with Ranexa. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.