Ranexa: Effective Chronic Angina Management for Stable Symptom Control
| Product dosage: 500mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.64 | $49.22 (0%) | 🛒 Add to cart |
| 60 | $1.29 | $98.44 $77.35 (21%) | 🛒 Add to cart |
| 90 | $1.15 | $147.67 $103.47 (30%) | 🛒 Add to cart |
| 120 | $1.05 | $196.89 $126.57 (36%) | 🛒 Add to cart |
| 180 | $0.95 | $295.33 $171.77 (42%) | 🛒 Add to cart |
| 270 | $0.90 | $443.00 $244.10 (45%) | 🛒 Add to cart |
| 360 | $0.87
Best per pill | $590.66 $311.40 (47%) | 🛒 Add to cart |
Ranexa (ranolazine) is an extended-release oral antianginal medication indicated for the treatment of chronic angina pectoris. It is used either alone or in combination with other antianginal agents such as amlodipine, beta-blockers, or nitrates when symptoms are not adequately controlled. Unlike traditional antianginal therapies, Ranexa works via a unique mechanism, inhibiting the late sodium current in cardiac cells, which reduces intracellular calcium overload and myocardial oxygen demand without significantly affecting heart rate or blood pressure. This profile makes it a valuable option for a broad range of patients, including those who cannot tolerate hemodynamic changes associated with other antianginal drugs. It is approved for use in adults and should be administered as part of a comprehensive cardiovascular risk management plan.
Features
- Active ingredient: Ranolazine
- Available as extended-release tablets: 500 mg and 1000 mg
- Unique mechanism of action: selective inhibitor of the late sodium current
- Does not cause clinically significant changes in heart rate or blood pressure
- Twice-daily dosing regimen for sustained 24-hour coverage
- Can be used as monotherapy or in combination with other antianginal agents
- Metabolized primarily by CYP3A enzymes, with considerations for drug interactions
Benefits
- Reduces frequency of angina attacks and nitroglycerin use
- Improves exercise tolerance and time to onset of angina in patients with chronic angina
- Offers a hemodynamically neutral profile, suitable for patients with hypotension or bradycardia
- Provides an additional therapeutic option when first-line agents are insufficient or contraindicated
- May be used in a wide spectrum of patients, including those with comorbid conditions like diabetes
- Supports long-term angina management with a favorable side effect profile for many individuals
Common use
Ranexa is commonly prescribed for the management of chronic angina pectoris in patients who have not achieved adequate symptom control with other antianginal medications. It is often used as add-on therapy to beta-blockers, calcium channel blockers, or nitrates, though it may also serve as monotherapy in cases where standard agents are not tolerated. The medication is particularly beneficial for individuals who experience limiting side effects from traditional antianginal drugs, such as significant hypotension or bradycardia. Clinical use is supported by evidence demonstrating improvements in exercise duration, time to angina onset, and reductions in weekly angina frequency.
Dosage and direction
The recommended starting dose of Ranexa is 500 mg taken orally twice daily. Based on clinical response and tolerability, the dose may be increased to a maximum of 1000 mg twice daily. Tablets should be swallowed whole and must not be crushed, chewed, or broken, as this alters the extended-release properties and may increase the risk of adverse effects. Ranexa can be taken with or without food, though consistency in administration is advised. Dose adjustments are necessary in patients with hepatic impairment, renal dysfunction, or when co-administered with certain CYP3A inhibitors. Treatment should be initiated under clinical supervision, and efficacy should be evaluated periodically.
Precautions
Ranexa should be used with caution in patients with pre-existing QT interval prolongation or those taking other drugs that prolong the QT interval, due to the potential for additive effects. Renal impairment (eGFR <30 mL/min) necessitates a reduced maximum dose of 500 mg twice daily. Hepatic impairment (moderate to severe) is a contraindication for use. Patients should be monitored for dizziness, nausea, or constipation, which may affect compliance or safety. Due to the risk of syncope, patients should avoid activities requiring mental alertness until they know how Ranexa affects them. It is not intended for the treatment of acute angina episodes.
Contraindications
Ranexa is contraindicated in patients with clinically significant hepatic impairment (Child-Pugh Class B or C). Concomitant use with strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin, ritonavir) is contraindicated due to significantly increased ranolazine exposure. It is also contraindicated with CYP3A inducers (e.g., rifampin, phenobarbital). Use in patients with a history of hypersensitivity to ranolazine or any component of the formulation is prohibited. Ranexa should not be used for the abortive treatment of acute anginal attacks.
Possible side effect
Common adverse reactions (≥4% incidence) include dizziness, headache, constipation, and nausea. Less frequently, patients may experience peripheral edema, vomiting, or dry mouth. QT interval prolongation has been observed in clinical studies, though the clinical significance remains uncertain. Serious but rare side effects include syncope, renal failure, or hallucinations. Most side effects are dose-related and may diminish over time or with dose adjustment. Patients should report any persistent or severe symptoms to their healthcare provider.
Drug interaction
Ranexa is primarily metabolized by CYP3A4 and to a lesser extent by CYP2D6, leading to several important interactions. Strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, clarithromycin) are contraindicated. Moderate inhibitors (e.g., diltiazem, verapamil, erythromycin) may require dose limitation. CYP3A inducers (e.g., rifampin, carbamazepine) reduce ranolazine plasma levels and should be avoided. Digoxin levels may increase with co-administration, requiring monitoring. Simvastatin exposure is elevated by ranolazine; dose limitation of simvastatin to 20 mg daily is recommended. Metformin and other OCT2 substrates may also interact.
Missed dose
If a dose of Ranexa is missed, the patient should take it as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended, as it may increase the risk of adverse effects. Patients should be advised to maintain a consistent dosing routine to ensure optimal therapeutic effect.
Overdose
In cases of suspected overdose, symptoms may include severe dizziness, syncope, nausea, vomiting, and QT prolongation. There is no specific antidote for ranolazine overdose. Management should include supportive measures, such as ECG monitoring for QT interval changes and treatment of symptoms. Hemodialysis is unlikely to be effective due to high protein binding and extensive metabolism. Patients should seek immediate medical attention or contact a poison control center if an overdose is suspected.
Storage
Ranexa should be stored at room temperature, between 20°C to 25°C (68°F to 77°F), in a dry place protected from light and moisture. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Unused medication should be disposed of properly according to local regulations or through a drug take-back program.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or discontinuing any medication or treatment plan. Individual patient needs and responses may vary. The prescribing physician should be guided by the full prescribing information and clinical judgment.
Reviews
Clinical trials and post-marketing surveillance have demonstrated that Ranexa is effective in reducing angina frequency and improving exercise tolerance in patients with chronic angina. Many patients report better quality of life and reduced reliance on sublingual nitroglycerin. Some users note side effects such as dizziness or constipation, though these often subside with continued use or dose adjustment. Healthcare providers appreciate its hemodynamically neutral profile, making it suitable for complex patients. Overall, it is regarded as a valuable addition to antianginal therapy, particularly where first-line options are limited.