Medications
Ranolazine - Ranexa
RANEXA is an antianginal indicated for the treatment of chronic angina.
Most common adverse reactions (>4% and more common than with placebo) are dizziness, headache, constipation, nausea.
• Moderate CYP3A inhibitors (e.g., diltiazem, verapamil, erythromycin): Limit RANEXA to 500 mg twice daily.
• P-gp inhibitors (e.g., cyclosporine): Ranolazine exposure increased. Titrate RANEXA based on clinical response.
• CYP3A substrates: Limit simvastatin to 20 mg when used with RANEXA. Doses of other sensitive CYP3A substrates (e.g., lovastatin) and CYP3A substrates with narrow therapeutic range (e.g., cyclosporine, tacrolimus, sirolimus) may need to be reduced with RANEXA.
• QT interval prolongation: Can occur with ranolazine. Little data available on high doses, long exposure, use with QT interval-prolonging drugs, potassium channel variants causing prolonged QT interval, in patients with a family history of (or congenital) long QT syndrome, or in patients with known acquired QT interval prolongation.
• Renal failure: Monitor renal function after initiation and periodically in patients with moderate to severe renal impairment (CrCL<60 mL/min). If acute renal failure develops, discontinue RANEXA.
