| name | Ranolazine |
| classification | Antianginal, Anti-ischemic agent |
| pharmacokinetics | | absorption | Ranolazine is absorbed from the gastrointestinal tract with variable absorption, with peak plasma concentrations occurring 2 to 6 hours after oral administration. | | distribution | Ranolazine is highly protein bound, primarily to albumin. | | metabolism | Ranolazine is extensively metabolized in the liver by CYP3A4, and to a lesser extent by CYP2D6 and CYP1A2. | | excretion | Ranolazine and its metabolites are primarily excreted in the urine. The elimination half-life is prolonged in patients with hepatic impairment. |
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| dosage | | initial dosage | Generally started at 500 mg twice daily, titrated up to a maximum of 1000 mg twice daily, aiming for a target steady-state trough concentration of 100-200 ng/mL. | | adult dosage | Dosage must be individualized based on response and adverse effects. Consult a healthcare professional for appropriate dosage. | | important note | Dosage adjustments may be necessary in patients with hepatic or renal impairment. |
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| indications | Ranolazine is used for the treatment of chronic angina, particularly when other treatments (beta-blockers, calcium channel blockers, nitrates) are ineffective or not tolerated. |
| safety in pregnancy | Pregnancy Category C. Limited data exist. Potential risks and benefits must be carefully considered by the prescribing physician. Use should be avoided unless clearly necessary. |
| safety in breastfeeding | It is unknown if ranolazine is excreted in breast milk. Use is not recommended due to potential risks to the infant. |
| side effects | | 1 | Headache | | 2 | Dizziness | | 3 | Constipation | | 4 | Nausea | | 5 | Vomiting | | 6 | Diarrhea | | 7 | Abdominal pain | | 8 | Vertigo | | 9 | Edema | | 10 | Lightheadedness | | 11 | Sleep disturbances | | 12 | Increased heart rate | | 13 | Heart palpitations | | 14 | Increased blood pressure | | 15 | Hypotension | | 16 | Arrhythmias | | 17 | Serious cardiac events | | 18 | Elevated liver enzymes |
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| alternatives | |
| contraindications | | 1 | Severe hepatic impairment | | 2 | Severe renal impairment (creatinine clearance <30 mL/min) | | 3 | Hypersensitivity to ranolazine | | 4 | Concomitant use with strong CYP3A4 inhibitors | | 5 | Severe hypotension | | 6 | Recent stroke or transient ischemic attack | | 7 | Known drug-induced long QT syndrome |
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| drug interactions | Ranolazine interacts with many medications, particularly those metabolized by CYP3A4. Careful monitoring and dosage adjustments may be necessary. A thorough medication reconciliation is crucial. |
| warnings and precautions | | 1 | Monitor ECG for QTc interval prolongation, especially during initial treatment or dose changes. | | 2 | Regular liver function tests are recommended during treatment. | | 3 | Patients with pre-existing cardiac conditions may require careful monitoring and dose adjustments. | | 4 | Caution is advised in patients with renal impairment or a history of QT prolongation. | | 5 | Avoid alcohol consumption while taking this medication. |
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| additional informations | | age considerations | Dosage and monitoring should be carefully evaluated by a healthcare professional, considering the patient's age and overall health. | | weight considerations | Weight is not a primary factor in adjusting the dosage, but overall health, including organ function, will be considered. | | special instructions | Do not discontinue use without consulting your healthcare provider. |
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| important disclaimer | This information is for educational purposes only and should not be substituted for professional medical advice. Always consult a healthcare provider before starting or changing any medication. |
