Ranexa (Ranolazine)

(℞) Prescription Required

    Ranexa (Ranolazine) Dosage and Side Effects

    RANEXA is used to treat chronic angina - spasmodic attacks of intense chest pain that occur when there's an insufficient supply of blood to the heart.

    Proper Use of this medication

    Taken orally, RANEXA comes in oblong-shaped, extended-release tablets of 500 milligrams (mg) and 1,000 mg.

    The recommended dosage is 500 mg twice a day to start, with an increase to 1,000 mg twice a day (the maximum recommended daily dose), depending on your symptoms.

    RANEXA can be taken with meals or not. Except for grapefruit, food has no significant effect on way the drug works.

    Swallow RANEXA tablets whole. Do not crush, break, or chew them.

    Your doctor may need to limit your dosage of RANEXA to 500 mg daily if you are using other medications for high blood pressure and chest pain, such as diltiazem (Cardizem) and verapamil (Calan), the antibiotic erythromycin, the fungal treatment fluconazole (Diflucan), and grapefruit juice or products containing grapefruit.

    RANEXA Overdose

    Call your doctor immediately, or go to the closest emergency room immediately.

    • Symptoms of an overdose can include dizziness, nausea, vomiting, confusion, double vision, pain, burning, numbness or tingling, and fainting.
    • Severe tremor, unsteady gait, inability to communicate (dysphasia), and hallucinations have been reported in cases of overdose.
    • Continuous ECG monitoring might be necessary in the case of an overdose.

    Missed Dose of RANEXA

    If you miss a dose of RANEXA, wait to take the next dose at your scheduled time.

    Do not "double up" and take more than one dose at a time.

    Side Effects

    Common Side Effects of RANEXA:

    • Dizziness
    • Headache
    • Constipation
    • Nausea

    Signs of an Allergic Reaction to RANEXA (Ranolazine):

    • Hives
    • Difficulty breathing
    • Swelled face, lips, tongue, or throat

    Seek medical help immediately at any sign of an allergic reaction.

    Serious Side Effects of RANEXA:

    • Fast, chaotic, irregular heart rhythm, coupled with feeling faint or lightheaded
    • Kidney failure in people who already have severe kidney disease
    • Swelled feet, hands, ankles
    • Tremors
    • Continuous ringing or buzzing in the ears
    • Blood in urine
    • Urinating less or not at all
    • Shortness of breath
    • Skin rash, tingling, numbness

    Seek medical help immediately if you have any of these serious side effects,especially if you feel faint, lightheaded, or feel your heart beating irregularly or erratically.

    These can be signs of QT prolongation, or long QT syndrome, which can bring on a sudden fainting spell or loss of consciousness, and if the irregular beating persists long enough, sudden death.

    While RANEXA seems to work equally well in patients 65 years old and in younger patients, patients older than 75 experienced serious side effects more frequently.

    Interactions with this medication

    RANEXA and Alcohol

    Drinking alcohol even in moderate amounts while taking Renaxa can exacerbate the side effects of dizziness and lightheadedness, so alcohol is best avoided.

    RANEXA and Drug Interactions

    RANEXA should not be taken with:

    • Clarithromycin (Biaxin) for infection
    • Ketoconazole (Nizoral), itraconazole (Sporanox, Ormel) for fungus infections
    • Nefazodone (Serzone) for depression
    • Nelfinavir (Viracept), ritonavir (Norvir), lopinavir and ritonavir (Kaletra), indinavir (Crixivan), saquinavir (Invirase) for HIV
    • Rifampin (Rifadin), rifabutin (Mycobutin), rifapentine (Priftin) for TB or other mycobacterial infections
    • Phenobarbital, phenytoin (Phenytek, Dilantin, Dilantin-125), carbamuazepine (Tegretol) for seizures
    • St. John's wort

    You also need to tell your doctor if you have cirrhosis (scarring) of your liver.

    RANEXA and Other Interactions

    Avoid grapefruit and grapefruit juice, and limit products that contain grapefruit, as they can increase the amount of RANEXA in your blood.

    Do not drive a car or operate machinery or do any other activity that requires coordination or mental alertness if you are experiencing dizziness, lightheadedness, or fainting.

    Warnings and Precautions

    The heart rhythm disorder called QT prolongation, or long QT syndrome, which can cause fast, irregular heartbeats, can occur when taking RANEXA.

    You need to let your doctor know if you or a family member has a history of QT prolongation.

    RANEXA also comes with a warning about possible kidney failure in patients who already have moderate to severe kidney impairment.

    Since you will need additional testing, inform your doctor if you have compromised kidney function before you begin treatment.

    Your doctor also needs to know if you have liver disease (e.g., cirrhosis), if you have any allergies, and about all the medications you take, whether prescription or over-the-counter, vitamins, illegal or recreational drugs, and dietary or herbal supplements, as they can affect how RANEXA works, and vice-versa.

    You must tell your doctor if you are taking St. John's wort, any medications for fungal infections or any other infections, depression, HIV, tuberculosis (TB), or seizures, as many medications used to treat these conditions should not be used with RANEXA.

    Medications you are taking for your heart, cholesterol, diabetes, or for nausea and vomiting brought on by chemotherapy, or any drugs you're taking to treat mental health problems, also need to be discussed.

    Pregnancy and RANEXA

    RANEXA might harm a pregnant woman's fetus. Nonetheless, the drug's benefits to the mother may outweigh the potential risks to her developing fetus.

    You should always tell your doctor if you are pregnant or might become pregnant.

    If you are breastfeeding or plan to breastfeed, it's not known if RANEXA is excreted in breast milk, so you need to decide with your doctor whether to take RANEXA or breastfeed, as you should not do both.

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    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.