Ranolazine ER

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Mar 18, 2024

Warnings

Ranolazine (Ranexa) Risks, Warnings, and Complications

Ranolazine can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatment options for chronic angina if you are at increased risk of complications from ranolazine use.

LONG QT SYNDROME: Ranolazine can cause a prolonged QT interval on ECG. This is a heart conduction abnormality. The risk of this occurring is higher in people who are on certain other medicines that can also lead to prolongation of the QT interval and in people with a family history of congenital long QT syndrome. Before starting ranolazine therapy, tell your doctor if you have a history of heart problems.
RENAL FAILURE: There are reports of severe renal impairment (reduced kidney function) and acute renal failure (kidney failure) in people taking ranolazine. Your doctor may order baseline tests to check kidney function before prescribing this antianginal medication. Tell your doctor if you have a history of kidney disease. Call your doctor without delay if you develop any urinary symptoms after starting this medicine. You may need to stop taking ranolazine if you develop increased serum creatinine and other signs of kidney problems.

Precautions Before Starting Ranolazine (Ranexa)

Tell your healthcare provider if you have ever had an unusual or allergic reaction to ranolazine, any of the active or inactive ingredients in ranolazine extended-release tablets or granules, other antianginal drugs, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications. This includes prescription drugs, over-the-counter medications, dietary supplements, and herbal products. It can help prevent dangerous interactions between your medications.

Give your doctor a complete medical history. Ranolazine may not be safe for people with certain medical conditions, such as hepatic impairment (liver disease), kidney disease, prolonged QT interval, irregular heartbeat, abnormalities on ECG, and low potassium.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breast-feeding.

Precautions During Use of Ranolazine (Ranexa)

Keep all your healthcare appointments during treatment with ranolazine. Your doctor may adjust your dose based on your response. They may order certain laboratory tests during ranolazine treatment.

Ranolazine can cause dizziness, lightheadedness, and blurred vision in some people. Do not drive or operate machinery until you know how this medicine affects you.

Do not drink grapefruit juice or eat grapefruit while taking ranolazine.

Avoid drinking alcohol while on ranolazine. Alcohol can make the side effects of ranolazine worse.

Tell your doctor if you become pregnant while on ranolazine.

Tell all your healthcare providers you are on ranolazine, especially before any surgery, including dental procedures.

Ranolazine (Ranexa) Drug Interactions

Certain medicines can affect how ranolazine works. Interactions between ranolazine and other medicines can increase the risk of severe adverse effects.

Your doctor may tell you not to take ranolazine if you are taking the following drugs:

Antifungal medications such as ketoconazole (Nizoral) and itraconazole (Onmel, Sporanox)
Antibiotics such as clarithromycin (Biaxin, in Prevpac)
Drugs used to treat HIV/AIDS such as ritonavir (Norvir, in Viekira Pak, in Kaletra, others), lopinavir and ritonavir (Kaletra), indinavir (Crixivan), nelfinavir (Viracept), and saquinavir (Invirase)
Antidepressants such as nefazodone
Anti-epileptic medications such as carbamazepine (Tegretol, Carbatrol, Equetro, others), phenytoin (Dilantin, Phenytek), and phenobarbital
Medications prescribed for tuberculosis, such as rifabutin (Mycobutin), rifapentine (Priftin), and rifampin (Rimactane, Rifadin, in Rifater, in Rifamate)
St. John's wort

Ranolazine can also have interactions with the following medications:

Medications used to treat heart rhythm abnormalities, such as amiodarone (Cordarone, Pacerone, Nexterone), quinidine (in Nuedexta), dofetilide (Tikosyn), and sotalol (Betapace, Sorine)
Antidepressants such as amitriptyline, desipramine (Norpramin), clomipramine (Anafranil), and imipramine (Tofranil)
Cholesterol-lowering drugs such as atorvastatin (Lipitor, in Caduet), simvastatin (Zocor, in Simcor, in Vytorin), and lovastatin (Altoprev, in Advicor)
Immunosuppressants such as cyclosporine (Gengraf, Sandimmune, Neoral), sirolimus (Rapamune), and tacrolimus (Astagraf, Envarsus XR, Prograf)
Medications for heart failure, such as digoxin (Lanoxin)
Calcium channel blockers such as diltiazem (Dilacor, Cardizem, Tiazac, others) and verapamil (Verelan, Calan, Covera, others)
Antibiotics such as erythromycin (Erythrocin, PCE, E.E.S.)
Antifungal agents such as fluconazole (Diflucan)
Psychiatric drugs prescribed for mental illness, such as risperidone (Risperdal), haloperidol (Haldol), thioridazine, and ziprasidone (Geodon)
Diabetes medications such as metformin (Glumetza, Fortamet, in Glucovance, others)

This is not a complete list of ranolazine drug interactions. Give your doctor and pharmacist a list of all the medicines you take, including prescription drugs, over-the-counter drugs, dietary supplements, and herbal products. Also, tell your healthcare professionals if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription medications.

Find the best discount on Ranolazine ER »