Ranolazine Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Ranolazine Tablet (generic name: ranolazine) is a prescription antianginal and anti-ischemic medicine used to treat chronic angina, or chest pain caused by coronary artery disease. It comes as an extended-release tablet or as granules that can be mixed into food, and it is taken regularly to reduce how often chest pain episodes happen. It cannot be used to stop a sudden angina attack and is often combined with other heart medicines when pain is not fully controlled on its own.

What is Ranolazine Tablet

Ranolazine is a prescription medicine used to treat chronic angina, which is chest pain caused by coronary artery disease. It comes as an extended-release tablet or as granules that can be mixed into food.

Ranolazine Tablet uses

• Used regularly to help reduce how often chronic chest pain episodes happen and to improve exercise tolerance.
• Often used together with other heart medicines such as beta-blockers, calcium channel blockers, nitrates, ACE inhibitors, angiotensin receptor blockers, antiplatelets, or cholesterol-lowering medicines when chest pain is not fully controlled by those drugs alone.
• Cannot be used to stop a sudden, acute angina attack or sudden chest pain.

Benefits of Ranolazine Tablet

• Helps the heart muscle use oxygen more efficiently so it can work with less strain.
• Generally does not significantly lower heart rate or blood pressure, unlike many other heart medicines.
• Offers a helpful option for patients who cannot tolerate or do not respond well to standard first-line angina treatments.

How Ranolazine Tablet works

Ranolazine is thought to work by helping the heart use oxygen more efficiently, so it can do more work without needing as much oxygen. This appears to happen without changing blood pressure or heart rate.

Ranolazine Tablet dosage

Take this medicine by mouth with a glass of water, at the same time every day. You may take it with or without food; if it upsets your stomach, take it with food. Swallow extended-release tablets whole — do not cut, crush, break, or chew them.

If using the granule form, sprinkle it on a spoonful of soft food like applesauce or yogurt and swallow right away without chewing or crushing. Granules can also be given through a feeding tube following specific mixing instructions from your pharmacist or care team.

Do not eat grapefruit or drink grapefruit juice while taking this medicine. Keep taking it regularly as prescribed; it must be taken consistently to work, and it should not be used to treat a sudden angina attack — use another medicine such as sublingual nitroglycerin for that, as directed by your doctor.

If you miss a dose, skip it and take your next dose at the regular time; do not double up.

Use exactly as prescribed by your doctor or pharmacist.

Available forms and strengths

• Extended-release tablet
• Extended-release oral granules (packet/sachet)

Side effects of Ranolazine Tablet

Common

• Dizziness or lightheadedness
• Headache
• Constipation
• Nausea or upset stomach
• Dry mouth
• Stomach pain

Serious

• Changes in heart rhythm (fast, pounding, or irregular heartbeat, dizziness, fainting, chest pain, trouble breathing) which can signal dangerous conditions like QT prolongation or torsade de pointes
• Signs of kidney problems such as blood in urine, reduced urination, swelling of the face, hands, or legs, unusual tiredness, nausea, vomiting, or weight gain
• Severe allergic reactions including swelling of the face, lips, tongue, or throat, trouble breathing, hives, or severe skin rash
• Low blood pressure or fainting, especially when standing up quickly

Warnings and precautions

• Do not use ranolazine to treat a sudden episode of chest pain — it only works to prevent chronic angina over time.
• Avoid grapefruit and grapefruit juice completely while taking this medicine, since they can raise drug levels in your body to dangerous amounts.
• This medicine should not be combined with a long list of other drugs, including certain antifungals, antibiotics, HIV medicines, seizure medicines, and St. John's wort, due to serious interaction risks.
• This medicine can cause changes in heart rhythm, including a serious condition called QT prolongation.
• There isn't enough human data to know how ranolazine affects pregnancy. Your doctor will need to weigh the potential benefits against possible risks to the baby before prescribing it during pregnancy.
• It isn't known whether ranolazine passes into breast milk. Talk with your doctor about the risks and benefits before taking it while breastfeeding.
• This medicine should be used carefully in people with severe kidney disease, as it may make kidney problems worse, and is not recommended in several stages of chronic kidney disease.
• This medicine should not be used by people with liver cirrhosis (scarring of the liver).
• Avoid drinking alcohol while using the extended-release granules, since alcohol can change how quickly the medicine is released and may increase side effects like dizziness.
• This medicine can cause dizziness, lightheadedness, or reduced alertness. Don't drive or use machinery until you know how it affects you.

Storage

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Keep from freezing.
• Keep out of the reach of children and pets.
• Do not keep outdated medicine or medicine no longer needed.
• Ask your healthcare professional or pharmacist how to dispose of unused medicine; some sources suggest using a medication take-back program, or mixing with an unwanted substance like cat litter or coffee grounds and sealing it in a bag before throwing it in the trash if a take-back option isn't available.

When to see a doctor

• Get medical help right away if you notice changes in your heart rhythm, such as feeling dizzy or faint, or a fast, pounding, or uneven heartbeat.
• Seek medical care right away for signs of a serious kidney problem, such as blood in the urine, reduced urination, increased thirst, swelling of the face or legs, trouble breathing, nausea, vomiting, or unusual weight gain.
• Stop taking this medicine and get help right away if you have signs of a serious allergic reaction, like trouble breathing, swelling of the face, lips, or throat, hives, or severe dizziness.
• If you think you've taken too much of this medicine, contact a poison control center or go to an emergency room right away.

Alternatives

• Metoprolol
• Diltiazem
• Amlodipine
• Nitroglycerin