How does this medication work? What will it do for me?

Ranolazine belongs to the class of medications called anti-anginals. It is used along with other medications to reduce the episodes of chest pain that occur with angina, when other medications haven't worked well enough or they cannot be used.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

The recommended starting dose of this medication is 500 mg taken by mouth, twice daily. Depending on how well it works to relieve symptoms, your doctor may gradually increase the dose to 1000 mg twice daily.

Ranolazine may be taken with or without meals. Swallow the tablets whole with some liquid. Do not crush, break, or chew the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

How should I use this medication?

500 mg
Each light-orange-coloured, film-coated, oblong-shaped tablet debossed with "C49" on one side and plain on the other side, contains 500 mg of ranolazine. Nonmedicinal ingredients: hypromellose, magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, Opadry II 85F570040 beige, Opadry II 32K520117 yellow, purified water, and sodium hydroxide.

1000 mg
Each yellow, film-coated, oblong-shaped tablet debossed with "C48" on one side and plain on the other side, contains 1000 mg of ranolazine. Nonmedicinal ingredients: hypromellose, magnesium stearate, methacrylic acid copolymer, microcrystalline cellulose, Opadry II 85F570040 beige, Opadry II 32K520117 yellow, purified water, and sodium hydroxide.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to ranolazine or any ingredients of the medication
  • have severely decreased kidney function
  • have moderately or severely decreased liver function
  • are taking any of the following medications:
    • amiodarone
    • carbamazepine
    • clarithromycin
    • disopyramide
    • dronedarone
    • HIV protease inhibitors (e.g., lopinavir, nelfinavir, ritonavir, saquinavir)
    • ketoconazole
    • phenobarbital
    • phenytoin
    • procainamide
    • quinidine
    • rifampin
    • rifabutin
    • St. John's wort
    • sotalol

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation
  • dizziness
  • headache
  • nausea

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred vision
  • confusion
  • hallucinations (e.g., seeing or hearing things that aren't there)
  • signs of kidney problems (e.g., decreased urine production, swelling, fatigue, abdominal pain)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • symptoms of irregular heartbeat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with ranolazine. If you have heart disease and abnormal heart rhythms, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with ranolazine. You are more at risk for this type of abnormal heart rhythm and its complications if you:

  • are female
  • are older than 65 years of age
  • have a family history of sudden cardiac death
  • have a history of heart disease or abnormal heart rhythms
  • have a slow heart rate
  • have congenital prolongation of the QT interval
  • have diabetes
  • have had a stroke
  • have low potassium, magnesium, or calcium levels
  • have nutritional deficiencies

If you have heart disease and abnormal heart rhythms, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Ranolazine may cause dizziness, blurred vision, confusion, reduced coordination, or hallucinations, which can affect your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.

Grapefruit juice: Grapefruit juice can interfere with how ranolazine is broken down and removed from the body. Consuming grapefruit juice while taking ranolazine may cause the medication to build up in the body, causing severe side effects.

Kidney function: People who have reduced kidney function may be at an increased risk of developing kidney failure. If you experience signs of kidney failure, such as decreased urine production, swelling, fatigue, and abdominal pain, contact your doctor as soon as possible.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if ranolazine passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: People over the age of 75 may be more at risk of experiencing side effects from ranolazine.

What other drugs could interact with this medication?

There may be an interaction between ranolazine and any of the following:

  • alprazolam
  • aliskiren
  • angiotensin converting enzyme inhibitors (ACEIs; captopril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
  • antiarrhythmics  (e.g., amiodarone, disopyramide, dronedarone, procainamide, propafenone, quinidine, sotalol)
  • apalutamide
  • aprepitant
  • "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • bilastine
  • bosentan
  • chlorpromazine
  • cobicistat
  • colchicine
  • conivaptan
  • cyclosporine
  • dabigatran
  • deferasirox
  • digoxin
  • diltiazem
  • doxorubicin
  • edoxaban
  • efavirenz
  • enzalutamide
  • elagolix
  • eliglustat
  • etoposide
  • etravirine
  • everolimus
  • flibanserin
  • grapefruit juice
  • haloperidol
  • HIV protease inhibitors (e.g., atazanavir, indinavir, lopinavir, ritonavir, saquinavir)
  • letermovir
  • lomitapide
  • lumacaftor and ivacaftor
  • macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
  • metformin
  • methadone
  • midazolam
  • mitotane
  • modafinil
  • morphine
  • nadolol
  • naloxegol
  • protein kinase inhibitors (e.g., dabrafenib, erdafitinib, imatinib, nilotinib, pazopanib, ribociclib)
  • pimozide
  • quinine
  • rifabutin
  • rifampin
  • rifaximin
  • risperidone
  • romidepsin
  • St. John's wort
  • sarilumab
  • seizure medications (e.g., carbamazepine, eslicarbazepine, phenobarbital, phenytoin, primidone)
  • silodosin
  • siltuximab
  • "statin" cholesterol medications (e.g., lovastatin, simvastatin)
  • sirolimus
  • stiripentol
  • tacrolimus
  • tocilizumab
  • topotecan
  • triazolam
  • velpatasvir
  • venetoclax
  • verapamil
  • vincristine
  • ziprasidone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Corzyna