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Specification
Requires Prescription (YES/NO)
Yes
Generics
Ranolazine
Used For
Angina
How it works
The mechanism of action of ranolazine is largely unknown. Ranolazine may have some antianginal effects by inhibition of the late sodium current in cardiac cells. This reduces intracellular sodium accumulation and consequently decreases intracellular calcium overload. Ranolazine, via its action to decrease the late sodium current, is considered to reduce these intracellular ionic imbalances during ischaemia. This reduction in cellular calcium overload is expected to improve myocardial relaxation and thereby decrease left ventricular diastolic stiffness. Clinical evidence of inhibition of the late sodium current by ranolazine is provided by a significant shortening of the QTc interval and an improvement in diastolic relaxation in an open-label study of 5 patients with a long QT syndrome (LQT3 having the SCN5A ?KPQ gene mutation).
Usage And Safety
Dosage
Ranolazine
Side Effects
Anorexia, decreased appetite, dehydration , hyponatremia , anxiety, insomnia, confusional state, hallucination , disorientation , dizziness, headache , lethargy, syncope, hypoaesthesia, somnolence, tremor, postural dizziness, paresthesia , amnesia, depressed level of consciousness, loss of consciousness, coordination abnormal, gait disturbance, parosmia , myoclonus. Eye disorders , blurred vision, visual disturbance, diplopia , Ear and labyrinth disorders , vertigo, tinnitus , impaired hearing , hot flush, hypotension , peripheral coldness, orthostatic hypotension .
Drug Interactions
Clarithromycin, telithromycin , itraconazole, ketoconazole, voriconazole, posaconazole, protease inhibitors, nefazodone, quinidine, dofetilide, or sotalol , erythromycin , fluconazole , ciclosporin, diltiazem or verapamil , phenytoin, carbamazepine, or phenobarbital, terfenadine, astemizole, mizolastine, disopyramide, procainamide, imipramine, doxepin, amitriptyline, bupropion, psychosis, efavirenz , cyclophosphamide , simvastatin, lovastatin, atorvastatin , tacrolimus, ciclosporin, sirolimus, everolimus .
Indication
It is indicated for the treatment of chronic angina.
When not to Use
Do not take - if you are allergic to ranolazine or any of the other ingredients of this medicine ; if you have severe kidney problems ; if you have moderate or severe liver problems ; if you are using certain medicines to treat bacterial infections (clarithromycin, telithromycin), fungal infections (itraconazole, ketoconazole, voriconazol, posaconazol), HIV infection (protease inhibitors), depression (nefazodone) or heart rhythm disorders (e.g. quinidine, dofetilide, or sotalol).
Precautions
Precaution
Caution should be taken in case of: • Concomitant administration of moderate CYP3A4 inhibitors . • Concomitant administration of P-gp inhibitors . • Mild hepatic impairment . • Mild to moderate renal impairment (creatinine clearance 30–80 ml/min). • Elderly • Patients with low weight (= 60 kg) • Patients with moderate to severe CHF (NYHA Class III–IV) .
Warnings
Warning 1
In patients with a combination of these factors, additional exposure increases are expected. Dose dependent side effects are likely to occur. If Ranolazine is used in patients with a combination of several of these factors, monitoring of adverse events should be frequent, the dose reduced, and treatment discontinued, if needed.
Warning 2
Co-administration with CYP3A4 inducers is expected to lead to lack of efficacy. Ranolazine should not be used in patients treated with CYP3A4 inducers (e.g. rifampicin, phenytoin, phenobarbital, carbamazepine, St. John’s Wort).
Warning 3
Caution should be observed when treating patients with a history of congenital or a family history of long QT syndrome, in patients with known acquired QT interval prolongation, and in patients treated with drugs affecting the QTc interval .
Additional Information
Pregnancy category
Always consult your physician before using any medicine.
Storage (YES/NO)
Store this medicine at room temperature, away from direct light and heat.
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