Ranolazine

What is Ranolazine

Ranolazine is a piperazine derivative and is the first novel drug approved for the treatment of chronic angina in over 20 years.

Ranolazine is unrelated to other available antianginal agents.

Ranolazine does not possess negative chronotropic or inotropic effects, and minimal effects on heart rate and blood pressure have been noted during clinical trials.

Brand Name

Ranexa

Indications

  • acute myocardial infarction, NSTEMI
  • angina
  • unstable angina

For the treatment of chronic angina

NOTE: The concomitant use of ranolazine and CYP3A inducers or strong CYP3A inhibitors is contraindicated.

NOTE: The effects of ranolazine on angina frequency and exercise tolerance are considerably smaller in women than in men.

Side Effects

  1. abdominal pain
  2. angioedema
  3. anorexia
  4. asthenia
  5. azotemia
  6. blurred vision
  7. bradycardia
  8. confusion
  9. constipation
  10. dizziness
  11. dyspepsia
  12. dyspnea
  13. dysuria
  14. eosinophilia
  15. hallucinations
  16. headache
  17. hematuria
  18. hyperhidrosis
  19. hypoesthesia
  20. hypoglycemia
  21. hypotension
  22. leukopenia
  23. myoclonia
  24. nausea
  25. orthostatic hypotension
  26. palpitations
  27. pancytopenia
  28. paresthesias
  29. peripheral edema
  30. pruritus
  31. pulmonary fibrosis
  32. QT prolongation
  33. rash
  34. renal failure (unspecified)
  35. syncope
  36. thrombocytopenia
  37. tinnitus
  38. tremor
  39. urinary retention
  40. vertigo
  41. vomiting
  42. xerostomia

Monitoring Parameters

  • ECG
  • LFTs
  • serum creatinine/BUN
  • serum magnesium
  • serum potassium

Contraindications

  • alcoholism
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • coronary artery disease
  • diabetes mellitus
  • driving or operating machinery
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • long QT syndrome
  • malnutrition
  • myocardial infarction
  • pregnancy
  • QT prolongation
  • renal failure
  • renal impairment
  • syncope
  • thyroid disease

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