Generic Name and Formulations:
Ranolazine 500mg, 1000mg; ext-rel tabs.
Gilead Sciences, Inc.
Indications for RANEXA:
Chronic angina; may be used with beta-blockers, nitrates, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, anti-platelet and lipid-lowering therapies.
Swallow whole. Initially 500mg twice daily, may increase to max 1g twice daily. Concomitant moderate CYP3A inhibitors (eg, diltiazem, verapamil, erythromycin, fluconazole, grapefruit-containing products): max 500mg twice daily. Concomitant P-gp inhibitors (eg, cyclosporine): titrate ranolazine dose based on response. Concomitant simvastatin: limit simvastatin to 20mg once daily. Concomitant metformin: give max metformin 1.7g/day if taking ranolazine 1g twice daily.
Severe hepatic impairment. Concomitant strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, saquinavir) or CYP3A inducers (eg, rifampin, rifabutin, rifapentine, phenobarbital, phenytoin, carbamazepine, St. John's wort).
Not for acute angina episodes or for treating diabetes. History of or congenital long QT syndrome. Monitor renal function after initiation and periodically in moderate-to-severe renal impairment. Discontinue if acute renal failure develops. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. Potentiates metformin; monitor glucose levels. May potentiate drugs metabolized by CYP3A (eg, simvastatin, lovastatin, cyclosporine, tacrolimus, sirolimus), P-gp transporters (eg, digoxin), CYP2D6 (eg, antipsychotics, tricyclic antidepressants); adjust doses of these drugs. May be potentiated by P-gp inhibitors (eg, cyclosporine). Caution with drugs that cause QT prolongation (eg, Class IA, Class III antiarrhythmics, thioridazine, ziprasidone).
Dizziness, headache, constipation, nausea; QT prolongation.
Clinical Pain Advisor Articles
- Virtual Reality May Effectively Reduce Sensory, Affective, and Cognitive Pain During Labor
- Suprazygomatic Sphenopalatine Ganglion Block May Quickly Relieve Status Migrainosus Pain
- Reducing Mortality After Overdose: Is Treatment for Opioid Use Disorder Effective?
- A Physician's Guide to Incorporating Patient Spirituality in Practice
- Low Literacy Self-Management Program for Chronic Pain May Be Effective
- Neuropathic Pain Medications
- Higher Buprenorphine Dose May Not Increase Severity of Neonatal Abstinence Syndrome
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Ketamine Infusions May Be Effective for Refractory Headache
- Physical, Psychosocial Activity May Be Protective Against Development of Chronic Pain in Older Adults
- The Challenge of Compassion in Modern Healthcare Settings
- Republican Opposition to Obamacare: What's Done, What's to Come
- Lowering Default Pill Counts in EMRs May Effectively Reduce Postoperative Opioid Prescription Numbers
- Steps Taken to Increase Use of Electronic Tools in Medicine
- Daily and Retrospective Pain Measurements Comparable in Hip Osteoarthritis