Ranolazine

Ranolazine is an anti-anginal medication. It works by improving blood flow to help the heart work more efficiently.

Ranolazine is used to treat chronic angina (chest pain). Ranolazine is not for use during an acute (emergency) attack of angina.

Ranolazine may also be used for purposes not listed in this medication guide.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Ranolazine may be found in some form under the following brand names:

• Ranexa

Antianginal agent; a piperazine derivative.1 2 3 4 6 9 10 11 12 13 14 15 16 18 19 20

Metabolized by CYP isoenzymes, principally CYP3A and, to a lesser extent, CYP2D6.1 6 9 10 11 15 16 19 20 Weak inhibitor of CYP isoenzyme 3A and moderate inhibitor of CYP isoenzyme 2D6.1 11 16 Does not inhibit CYP isoenzymes 1A2, 2C8, 2C9, 2C19, or 2E1.1 24

Substrate and moderate inhibitor of the p-glycoprotein transport system.1 11 16

Drugs Affecting Hepatic Microsomal Enzymes

CYP3A and 2D6 inhibitors: Potential pharmacokinetic interaction (increased plasma ranolazine concentrations).1 Avoid concomitant use with potent CYP3A inhibitors.1 Maximum ranolazine dosage of 500 mg twice daily in patients receiving moderate CYP3A inhibitors (see Specific Drugs and Foods under Interactions).1

Drugs Metabolized by Hepatic Microsomal Enzymes

CYP3A and 2D6 substrates: Potential pharmacokinetic interaction (increased plasma concentration of substrate).1

Drugs that Inhibit the p-Glycoprotein Transport System

Potential pharmacokinetic interaction (increased absorption of ranolazine) with p-glycoprotein inhibitors.1 11 16 19 Reduce dosage of ranolazine as needed based on clinical response in patients receiving p-glycoprotein inhibitors (see Specific Drugs and Foods under Interactions).1

Drugs That Prolong QT Interval

Potential pharmacologic effect (additive effect on QT interval prolongation).11 Experience with concomitant use of ranolazine with drugs that prolong the QT interval is limited.1

Specific Drugs and Foods

• Exact mechanism of antianginal action not fully elucidated; may involve the shifting of adenosine triphosphate (ATP) production away from fatty acid oxidation (i.e., partial inhibition of fatty acid oxidation) in favor of more oxygen-efficient glucose oxidation, especially when free fatty acid concentrations are elevated (e.g., during ischemia), leading to reduced oxygen demand and symptoms of ischemia without affecting cardiac work.1 2 3 4 9 10 11 14 15 17 18

• May decrease the magnitude of the late (i.e., sustained, persistent) sodium current1 resulting in a net reduction in intracellular sodium concentrations, reversal of calcium overload, restoration of ventricular pump function, and prevention of ischemia-induced arrhythmias.10 11 12 13 15 16 17 18 19

• Effects not dependent upon reductions in heart rate or BP.1 2 3 7 9 10 12 13 14 15 16 17 20

• Prolongation of QT interval secondary to inhibition of IKr, which prolongs the ventricular action potential.1

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ranolazine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ranolazine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ranolazine in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ranolazine in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving ranolazine.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ranolazine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ranolazine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Amifampridine
• Amisulpride
• Amitriptyline
• Amoxapine
• Amprenavir
• Atazanavir
• Bepridil
• Carbamazepine
• Cisapride
• Clarithromycin
• Clomipramine
• Cobicistat
• Colchicine
• Darunavir
• Desipramine
• Doxepin
• Dronedarone
• Fosamprenavir
• Fosphenytoin
• Idelalisib
• Imipramine
• Indinavir
• Itraconazole
• Ketoconazole
• Lopinavir
• Mesoridazine
• Nefazodone
• Nelfinavir
• Nortriptyline
• Phenobarbital
• Phenytoin
• Pimozide
• Piperaquine
• Posaconazole
• Protriptyline
• Rifabutin
• Rifampin
• Rifapentine
• Ritonavir
• Saquinavir
• Sparfloxacin
• St John's Wort
• Terfenadine
• Thioridazine
• Trimipramine
• Ziprasidone

Using ranolazine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acecainide
• Afatinib
• Alfentanil
• Alfuzosin
• Amiodarone
• Anagrelide
• Apomorphine
• Aprepitant
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Artemether
• Asenapine
• Astemizole
• Azimilide
• Azithromycin
• Bedaquiline
• Betrixaban
• Bretylium
• Buserelin
• Ceritinib
• Chloroquine
• Chlorpromazine
• Ciprofloxacin
• Citalopram
• Clozapine
• Conivaptan
• Crizotinib
• Cyclobenzaprine
• Cyclosporine
• Dabigatran Etexilate
• Dabrafenib
• Dasatinib
• Degarelix
• Delamanid
• Deslorelin
• Deutetrabenazine
• Digoxin
• Dihydroergotamine
• Diltiazem
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Droperidol
• Efavirenz
• Eliglustat
• Ergotamine
• Erythromycin
• Escitalopram
• Fentanyl
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fosaprepitant
• Foscarnet
• Gatifloxacin
• Gemifloxacin
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Ivabradine
• Lapatinib
• Leuprolide
• Levofloxacin
• Lovastatin
• Lumefantrine
• Mefloquine
• Methadone
• Metronidazole
• Mifepristone
• Morphine
• Morphine Sulfate Liposome
• Moxifloxacin
• Nafarelin
• Netupitant
• Nilotinib
• Norfloxacin
• Octreotide
• Ofloxacin
• Ondansetron
• Paliperidone
• Panobinostat
• Pasireotide
• Pazopanib
• Pimavanserin
• Pitolisant
• Pixantrone
• Prochlorperazine
• Promethazine
• Propafenone
• Quetiapine
• Quinidine
• Quinine
• Ribociclib
• Salmeterol
• Sematilide
• Sevoflurane
• Simeprevir
• Simvastatin
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sorafenib
• Sotalol
• Sulpiride
• Sunitinib
• Tacrolimus
• Tedisamil
• Telithromycin
• Tetrabenazine
• Tizanidine
• Topotecan
• Toremifene
• Trazodone
• Trifluoperazine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Venetoclax
• Verapamil
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Voriconazole
• Zuclopenthixol

Using ranolazine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Metformin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ranolazine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use ranolazine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of ranolazine. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart rhythm problems (eg, QT prolongation, long QT syndrome), or history of or
• Kidney disease, severe—Use with caution. May make these conditions worse.

• Liver cirrhosis—Should not be used in patients with this condition.

• It is used to treat a type of long-term chest pain (stable angina) in some people.

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take with or without food.
• Keep taking ranolazine as you have been told by your doctor or other health care provider, even if you feel well.
• To gain the most benefit, do not miss doses.
• Swallow whole. Do not chew, break, or crush.

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Cmax is increased by 30% in cirrhotic patients with mild (Child-Pugh class A) hepatic impairment and 80% in cirrhotic patients with moderate (Child-Pugh class B) hepatic impairment.

Refer to adult dosing. Select dose cautiously, starting at the lower end of the dosing range.

Limit the use of grapefruit juice; the ranolazine dose should not exceed 500 mg twice daily when taken with grapefruit juice or grapefruit-containing products.

Afatinib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Afatinib. Management: Per US labeling: reduce afatinib by 10mg if not tolerated. Per Canadian labeling: avoid combination if possible; if used, administer the P-gp inhibitor simultaneously with or after the dose of afatinib. Consider therapy modification

Antifungal Agents (Azole Derivatives, Systemic): May decrease the metabolism of Ranolazine. Fluconazole and isavuconazonium considerations are addressed in separate monographs. Exceptions: Fluconazole; Isavuconazonium Sulfate. Avoid combination

ARIPiprazole: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy

ARIPiprazole: CYP2D6 Inhibitors (Weak) may increase the serum concentration of ARIPiprazole. Management: Monitor for increased aripiprazole pharmacologic effects. Aripiprazole dose adjustments may or may not be required based on concomitant therapy and/or indication. Consult full interaction monograph for specific recommendations. Monitor therapy

AtorvaSTATin: Ranolazine may increase the serum concentration of AtorvaSTATin. Monitor therapy

Betrixaban: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Betrixaban. Management: Decrease the betrixaban dose to an initial single dose of 80 mg followed by 40 mg once daily if combined with a P-glycoprotein inhibitor. Consider therapy modification

Bilastine: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Bilastine. Management: Consider alternatives when possible; bilastine should be avoided in patients with moderate to severe renal insufficiency who are receiving p-glycoprotein inhibitors. Consider therapy modification

Brentuximab Vedotin: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Brentuximab Vedotin. Specifically, concentrations of the active monomethyl auristatin E (MMAE) component may be increased. Monitor therapy

Calcium Channel Blockers (Nondihydropyridine): May increase the serum concentration of Ranolazine. Management: Limit ranolazine dose to a maximum of 500 mg twice daily when used with diltiazem or verapamil. Exceptions: Bepridil. Consider therapy modification

Celiprolol: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Celiprolol. Monitor therapy

Colchicine: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Colchicine. Colchicine distribution into certain tissues (e.g., brain) may also be increased. Management: Colchicine is contraindicated in patients with impaired renal or hepatic function who are also receiving a p-glycoprotein inhibitor. In those with normal renal and hepatic function, reduce colchicine dose as directed. Consider therapy modification

Conivaptan: May increase the serum concentration of CYP3A4 Substrates. Avoid combination

CYP3A4 Inducers (Moderate): May decrease the serum concentration of Ranolazine. Avoid combination

CYP3A4 Inducers (Strong): May decrease the serum concentration of Ranolazine. Avoid combination

CYP3A4 Inhibitors (Moderate): May increase the serum concentration of Ranolazine. Management: Limit the ranolazine adult dose to a maximum of 500 mg twice daily in patients concurrently receiving moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil, erythromycin, etc.). Consider therapy modification

CYP3A4 Inhibitors (Strong): May increase the serum concentration of Ranolazine. Avoid combination

Dabigatran Etexilate: P-glycoprotein/ABCB1 Inhibitors may increase serum concentrations of the active metabolite(s) of Dabigatran Etexilate. Management: Dabigatran dose reductions may be needed. Specific recommendations vary considerably according to US vs Canadian labeling, specific P-gp inhibitor, renal function, and indication for dabigatran treatment. Refer to full monograph or dabigatran labeling. Consider therapy modification

Dasatinib: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy

Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy

Digoxin: Ranolazine may increase the serum concentration of Digoxin. Monitor therapy

DOXOrubicin (Conventional): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of DOXOrubicin (Conventional). Management: Seek alternatives to P-glycoprotein inhibitors in patients treated with doxorubicin whenever possible. One U.S. manufacturer (Pfizer Inc.) recommends that these combinations be avoided. Consider therapy modification

Edoxaban: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Edoxaban. Management: See full monograph for details. Reduced doses are recommended for patients receiving edoxaban for venous thromboembolism in combination with certain inhibitors. Similar dose adjustment is not recommended for edoxaban use in atrial fibrillation. Consider therapy modification

Everolimus: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Everolimus. Management: Everolimus dose reductions are required for patients being treated for subependymal giant cell astrocytoma or renal cell carcinoma. See prescribing information for specific dose adjustment and monitoring recommendations. Consider therapy modification

Flibanserin: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Flibanserin. Monitor therapy

Fosaprepitant: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy

Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates. Avoid combination

Highest Risk QTc-Prolonging Agents: QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying) may enhance the QTc-prolonging effect of Highest Risk QTc-Prolonging Agents. Management: Avoid such combinations when possible. Use should be accompanied by close monitoring for evidence of QT prolongation or other alterations of cardiac rhythm. Consider therapy modification

HYDROcodone: CYP3A4 Inhibitors (Weak) may increase the serum concentration of HYDROcodone. Monitor therapy

Idelalisib: May increase the serum concentration of CYP3A4 Substrates. Avoid combination

Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day. Consider therapy modification

Lovastatin: Ranolazine may enhance the myopathic (rhabdomyolysis) effect of Lovastatin. Ranolazine may increase the serum concentration of Lovastatin. Ranolazine may also enhance the distribution of lovastatin to specific cells/tissues/organs where P-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.). Monitor therapy

MetFORMIN: Ranolazine may increase the serum concentration of MetFORMIN. Management: Limit the metformin dose to a maximum of 1700 mg/day when used together with ranolazine 1000 mg twice daily. Consider therapy modification

Moderate Risk QTc-Prolonging Agents: QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying) may enhance the QTc-prolonging effect of Moderate Risk QTc-Prolonging Agents. Monitor therapy

Naldemedine: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Naldemedine. Monitor therapy

Naloxegol: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Naloxegol. Monitor therapy

NiMODipine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of NiMODipine. Monitor therapy

Palbociclib: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy

PAZOPanib: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of PAZOPanib. Avoid combination

Perhexiline: CYP2D6 Inhibitors (Weak) may increase the serum concentration of Perhexiline. Monitor therapy

P-glycoprotein/ABCB1 Inhibitors: May increase the serum concentration of Ranolazine. Monitor therapy

P-glycoprotein/ABCB1 Substrates: Ranolazine may increase the serum concentration of P-glycoprotein/ABCB1 Substrates. Monitor therapy

Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Avoid combination

Prucalopride: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Prucalopride. Monitor therapy

RifAMPin: May decrease the serum concentration of Ranolazine. Avoid combination

RifAXIMin: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of RifAXIMin. Monitor therapy

Sarilumab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy

Silodosin: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Silodosin. Avoid combination

Siltuximab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy

Simeprevir: May increase the serum concentration of CYP3A4 Substrates. Monitor therapy

Simvastatin: Ranolazine may increase the serum concentration of Simvastatin. Management: Avoid the concurrent use of ranolazine with simvastatin when possible. If used together, avoid doses of simvastatin greater than 20 mg/day. Consider therapy modification

St John's Wort: May decrease the serum concentration of Ranolazine. Avoid combination

Stiripentol: May increase the serum concentration of CYP3A4 Substrates. Management: Use of stiripentol with CYP3A4 substrates that are considered to have a narrow therapeutic index should be avoided due to the increased risk for adverse effects and toxicity. Any CYP3A4 substrate used with stiripentol requires closer monitoring. Consider therapy modification

Tacrolimus (Systemic): Ranolazine may increase the serum concentration of Tacrolimus (Systemic). Monitor therapy

Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Monitor therapy

Topotecan: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Topotecan. Avoid combination

Venetoclax: P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of Venetoclax. Management: Reduce the venetoclax dose by at least 50% in patients requiring these combinations. Consider therapy modification

VinCRIStine (Liposomal): P-glycoprotein/ABCB1 Inhibitors may increase the serum concentration of VinCRIStine (Liposomal). Avoid combination

Applies to ranolazine: oral tablet extended release

Along with its needed effects, ranolazine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ranolazine:

• Dizziness

• Bloating or swelling of the face, arms, hands, lower legs, or feet
• continuous ringing or buzzing or other unexplained noise in the ears
• difficult or labored breathing
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling of constant movement of self or surroundings
• hearing loss
• lightheadedness
• rapid weight gain
• sensation of spinning
• tightness in the chest
• tingling of the hands or feet
• unusual weight gain or loss

• Abnormal or decreased touch sensation
• agitation
• blood in the urine
• blurred vision
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• chest pain or discomfort
• chills
• cold sweats
• coma
• confusion
• decreased urine output
• depression
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• headache
• hostility
• irritability
• lethargy
• muscle twitching
• nausea
• seizures
• shakiness in the legs, arms, hands, or feet
• slow or irregular heartbeat
• stupor
• sweating
• trembling or shaking of the hands or feet
• unusual tiredness or weakness

Some side effects of ranolazine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Difficulty having a bowel movement (stool)

• Dry mouth
• stomach pain

• Lack or loss of strength

Applies to ranolazine: oral tablet extended release

General

The most common adverse reactions were dizziness, headache, constipation, and nausea.[Ref]

Gastrointestinal

Common (1% to 10%): Constipation, nausea, vomiting
Uncommon (0.1% to 1%): Abdominal pain, dry mouth, dyspepsia, flatulence, stomach discomfort
Rare (less than 0.1%): Pancreatitis, erosive duodenitis, oral hypoesthesia[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache
Uncommon (0.1% to 1%): Lethargy, syncope, hypoesthesia, somnolence, tremor, postural dizziness, paresthesia, vertigo, tinnitus
Rare (less than 0.1%): Amnesia, depressed level of consciousness, loss of consciousness, coordination abnormal, gait disturbance, parosmia[Ref]

Other

Common (1% to 10%): Asthenia
Uncommon (0.1% to 1%): Fatigue, peripheral edema
Rare (less than 0.1%): Impaired hearing[Ref]

Metabolic

Uncommon (0.1% to 1%): Anorexia, appetite decreased, dehydration, weight decreased
Rare (less than 0.1%): Hyponatremia
Postmarketing reports: Hypoglycemia[Ref]

Psychiatric

Uncommon (0.1% to 1%): Anxiety, insomnia, confusional state, hallucination
Rare (less than 0.1%): Disorientation[Ref]

Musculoskeletal

Uncommon (0.1% to 1%): Pain in extremity, muscle cramp, joint swelling, muscular weakness[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Hot flush, hypotension, prolonged QT corrected interval
Rare (less than 0.1%): Peripheral coldness, orthostatic hypotension
Frequency not reported: Bradycardia, palpitations[Ref]

Genitourinary

Uncommon (0.1% to 1%): Dysuria, hematuria, chromaturia
Rare (less than 0.1%): Urinary retention, erectile dysfunction[Ref]

Respiratory

Uncommon (0.1% to 1%): Dyspnea, cough, epistaxis
Rare (less than 0.1%): Throat tightness
Frequency not reported: Pulmonary fibrosis[Ref]

Ocular

Uncommon (0.1% to 1%): Blurred vision, visual disturbance, diplopia[Ref]

Renal

Uncommon (0.1% to 1%): Serum creatinine increased, blood urea increased
Rare (less than 0.1%): Acute renal failure
Frequency not reported: Blood urea increased[Ref]

Dermatologic

Uncommon (0.1% to 1%): Pruritus, hyperhidrosis
Rare (less than 0.1%): Angioedema, urticaria, cold sweat, rash[Ref]

Hematologic

Uncommon (0.1% to 1%): Platelet or white blood cell count increased
Frequency not reported: Eosinophilia, thrombocytopenia, leukopenia, pancytopenia[Ref]

Hepatic

Rare (less than 0.1%): Hepatic enzyme levels elevated[Ref]

Some side effects of ranolazine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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