ranexa

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

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

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

Important information

You should not take Ranexa if you have cirrhosis of the liver.

Many other drugs can interact with ranolazine and should not be used at the same time. Your doctor may need to change your treatment plan if you use certain medicines to treat infections, HIV or AIDS, depression, seizures, or tuberculosis.

Ranexa is not for use during an acute (emergency) attack of angina. Continue using any other medicines prescribed by your doctor (such as nitroglycerin) to treat acute angina.

Before you take Ranexa, tell your doctor about all of your medical conditions, especially if you have a personal or family history of Long QT syndrome.

Chronic angina is often treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.

Before taking this medicine

You should not take Ranexa if you are allergic to ranolazine, or if you have cirrhosis of the liver.

Many other drugs can interact with ranolazine and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

• clarithromycin;

• nefazodone;

• St. John"s wort;

• antifungal medicine - itraconazole, ketoconazole;

• HIV or AIDS medicine - indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir;

• tuberculosis medicine - rifabutin, rifampin, rifapentine; or

• seizure medicine-carbamazepine, phenobarbital, phenytoin.

To make sure Ranexa is safe for you, tell your doctor if you have:

• a heart rhythm disorder;

• liver disease;

• kidney disease; or

• a personal or family history of long QT syndrome.

FDA pregnancy category C. It is not known whether Ranexa will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether ranolazine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using Ranexa.

How should I take Ranexa?

Take Ranexa exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Ranexa may be taken with or without food.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Call your doctor if your symptoms do not improve, or if they get worse while using Ranexa.

Chronic angina is often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor"s advice.

Store Ranexa at room temperature away from moisture and heat.

Ranexa Dosing Information

Usual Adult Dose of Ranexa for Angina Pectoris:

Initial dose: 500 mg orally twice daily
Maintenance dose: 500 mg to 1000 mg orally twice daily. Maximum recommended dose is 1000 mg twice daily.

What happens if I miss a dose?

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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose can cause nausea, vomiting, numbness or tingling, dizziness, double vision, confusion, or fainting.

What should I avoid while taking Ranexa?

Ranexa may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Grapefruit and grapefruit juice may interact with ranolazine and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Ranexa side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Ranexa: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• headache with chest pain and severe dizziness, fast or pounding heartbeats; or

• signs of a kidney problem - little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath.

Common Ranexa side effects may include:

• nausea, constipation;

• headache; or

• dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Ranexa?

Many drugs can interact with Ranexa. Below is just a partial list. Tell your doctor if you are using:

• aprepitant (Emend);

• arsenic trioxide (Trisenox);

• chloroquine (Aralen);

• digoxin (Lanoxin);

• fluconazole (Diflucan);

• lovastatin (Mevacor, Altoprev, Advicor), simvastatin (Zocor, Simcor, Vytorin);

• tamsulosin (Flomax);

• tolterodine (Detrol);

• ADHD medication such as atomoxetine (Strattera), dextroamphetamine (Adderall), methamphetamine (Desoxyn), methylphenidate (Ritalin, Daytrana, Metadate, Concerta);

• an antibiotic such as azithromycin (Zithromax), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), pentamidine (NebuPent, Pentam);

• an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), duloxetine (Cymbalta), fluoxetine (Prozac, Sarafem, Symbyax), imipramine (Tofranil), mirtazepine (Remeron), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), venlafaxine (Effexor), and others;

• cancer medicine such as doxorubicin (Adriamycin, Doxil), lomustine (CeeNU), tamoxifen (Soltamox);

• cough medicine such as dextromethorphan (Delsym, Robitussin Maximum Strength, Vicks 44, and others) or dihydrocodeine (Alahist DHC, J-Max DHC, Pancof-PD, Panlor, Trezix, Welltuss EXP, and others);

• heart or blood pressure medicine such as amiodarone (Cordarone, Pacerone), betaxolol (Kerlone), captopril (Capoten), carvedilol (Coreg), diltiazem (Cartia, Cardizem), dofetilide (Tikosyn), disopyramide (Norpace), dronedarone (Multaq), flecainide (Tambocor), ibutilide (Corvert), labetalol (Normodyne), metoprolol (Dutoprol, Lopressor, Toprol), mexilitene (Mexitil), nicardipine (Cardene), quinidine (Quin-G), pindolol (Visken), procainamide (Procan, Pronestyl), propafenone (Rythmol), propranolol (Inderal, InnoPran), sotalol (Betapace, Sorine), timolol (Blocadren), or verapamil (Calan, Covera, Isoptin);

• medicine to prevent or treat nausea and vomiting such as dolasetron (Anzemet), droperidol (Inapsine), or ondansetron (Zofran);

• medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), fluphenazine (Permitil), haloperidol (Haldol), pimozide (Orap), promethazine (Phenergan), perphenazine (Trilafon), risperidone (Risperdal), thioridazine (Mellaril), or ziprasidone (Geodon);

• medicine used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf);

• migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig);

• narcotic medication such as methadone (Methadose, Diskets, Dolophine); or

• pain medication such as codeine (Tylenol #3), hydrocodone (Lortab, Vicodin, Vicoprofen), oxycodone (OxyContin, Percocet), or tramadol (Ultram, Ultracet).

This list is not complete and here are many other drugs that can interact with Ranexa. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.