ranolazine
Ranolazine (Ranexa) is an oral medication used to treat chest pain (angina). It's usually added to other medications when they aren't working well enough. Ranolazine (Ranexa) extended-release tablets are available in brand-name and lower-cost generic forms, but the extended-release granules (Aspruzyo Sprinkle) are available as a brand-name form only.
What is Ranolazine (Ranexa)?
What is Ranolazine (Ranexa) used for?
- A certain type of long-term chest pain (chronic angina)
How Ranolazine (Ranexa) works
Ranolazine (Ranexa) is an antianginal medication. Angina (chest pain) happens when the heart muscle isn't getting enough oxygen. The way ranolazine (Ranexa) works to treat angina isn't completely understood. But it's thought to help your heart work more efficiently by changing the flow of electrolytes in the heart. This might help lower the symptoms of angina.
Drug facts
Side effects of Ranolazine (Ranexa)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (6%)
- Headache (6%)
- Constipation (5%)
- Nausea (4%)
Less Common Side Effects
- Palpitations (racing heart)
- Dry mouth
- Stomach pain
- Vomiting
- Swelling (due to excess fluid) in the arms or legs
Ranolazine (Ranexa) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Abnormal heart rhythm: abnormal heart rate, dizziness, difficulty breathing, chest pain, fainting
- Serious kidney problems: tiredness, blood or foam in your urine, urinating more often, muscle cramping, swollen feet or ankles, poor appetite
The following Ranolazine (Ranexa) side effects have also been reported
Along with its needed effects, a medicine 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:
More common
Dizziness
Less common
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
Rare
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
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
headache
hostility
irritability
lethargy
muscle twitching
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 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:
More common
Difficulty having a bowel movement (stool)
Rare
Lack or loss of strength
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
Pros and cons of Ranolazine (Ranexa)
Pros
- Makes you less likely to get chest pain from exercise
- Safe to use if you have heart failure or diabetes
- Can take with or without food
- Tablets available as a lower-cost generic
- Also available as a granule formulation if you can't swallow pills or have a feeding tube
Cons
- Not good for treating chest pain after it's started
- Not usually a first-choice treatment for angina
- Typically must take twice daily
- Can interact with several medications, including certain heart or cholesterol medications
- Not recommended if you have serious liver problems
Pharmacist tips for Ranolazine (Ranexa)
- Take ranolazine (Ranexa) twice daily, with or without food.
- Ranolazine (Ranexa) can cause dizziness and lightheadedness. Avoid driving, operating machinery, or doing tasks that require you to be alert until you know how this medication will affect you.
- Ranolazine (Ranexa) can lower the risk of chest pain and improve your ability to exercise. But it can take several weeks before you feel a noticeable difference. Continue taking ranolazine (Ranexa) as directed by your healthcare team. Let them know if you're not sure what to expect once you start treatment.
- Many medications can interact with ranolazine (Ranexa) and lead to more side effects. Let your provider or pharmacist know all of the medications you take, including supplements and over-the-counter medications. In some situations, you won't be able to take more than 500 mg twice daily due to major drug interactions.
- Limit the amount of grapefruit and grapefruit juice you have while taking ranolazine (Ranexa). Grapefruit can make ranolazine (Ranexa) levels higher in the body, potentially leading to more side effects.
- Ranolazine (Ranexa) doesn't work very fast, so it won't help relieve chest pain once it starts. Faster-acting medications, like nitroglycerin sublingual tablets (Nitrostat), are better for quickly treating an episode of angina.
For the extended-release tablets
- Swallow the tablets whole. Don't crush, break, or chew them, since this can affect how ranolazine (Ranexa) works in the body.
For the extended-release oral granules (Aspruzyo Sprinkle)
- Sprinkle the granules onto one tablespoonful of soft food (applesauce or yogurt), and eat the mixture right away. Avoid chewing or crushing the granules.
- If you have a feeding tube, such as a nasogastric (NG) tube or gastric (G) tube, be sure to follow the specific instructions to mix Aspruzyo Sprinkle with water before giving the medication through the tube. This includes mixing the medication with the correct amount of water. Ask your provider or pharmacist if you have any questions about how to give the medication through a feeding tube.
Common questions about Ranolazine (Ranexa)
Even though ranolazine (Ranexa) prevents chest pain, it hasn't been shown to prevent future heart attacks. But, this medication is typically used along with other heart medications that can help prevent heart attacks, like antiplatelet medications (e.g., clopidogrel (Plavix)) or ACE inhibitors (e.g., lisinopril (Zestril)).
No, ranolazine (Ranexa) isn't a beta blocker. Even though beta blockers are sometimes used for angina, they're typically used for heart rhythm problems and high blood pressure. Ranolazine (Ranexa) works differently than beta blockers and isn't approved for any use other than angina. This medication is often prescribed along with beta blockers (e.g., metoprolol (Lopressor), carvedilol (Coreg)) to help with certain heart problems.
Ranolazine (Ranexa) doesn't typically lower your blood pressure. Ranolazine (Ranexa) isn't like some other medications for angina that usually lower blood pressure, such as nitroglycerin sublingual tablets (Nitrostat) and beta blockers. Discuss with your provider if ranolazine (Ranexa) is right for you based on your needs or concerns.
Weight gain isn't a common side effect of ranolazine (Ranexa), but the medication can cause edema (excess fluid) in the arms and legs. The extra water weight could potentially cause you to become heavier. Talk to your provider if you experience any changes in weight or swelling in your arms and legs that concern you.
If you miss a dose of ranolazine (Ranexa), skip the missed dose. Wait to take your next prescribed dose at the next scheduled time. Don't double up on your next dose to make up for the one you missed, since this can raise your risk of side effects.
How to save using GoodRx
Risks and warnings for Ranolazine (Ranexa)
Ranolazine (Ranexa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Abnormal heart rhythm
- Risk factors: Previous history or family history of "long QT" syndrome | Taking other medications that prolong the QT interval
Ranolazine (Ranexa) can affect the natural rhythm of your heart and cause it to beat abnormally. Your provider might regularly monitor your heart through electrocardiograms or EKGs (a test of your heart's electrical activity) to make sure this doesn't become a serious problem. Don't take more ranolazine (Ranexa) than prescribed, and let your provider know if you have a personal or family history of "long QT" syndrome. Also let your provider and pharmacist know about all of the other medications you take. Taking other medications that cause this heart rhythm problem with ranolazine (Ranexa) can raise your risk of experiencing it. If you have an abnormal heart rate, chest pain, dizziness, difficulty breathing, or fainting, get medical care right away.
Kidney problems
- Risk factors: History of serious kidney problems
Ranolazine (Ranexa) can cause your kidneys to not work as well, especially if you already have kidney problems. If necessary, your provider will check your kidney health through blood work regularly. If you develop new or worsening kidney problems, your provider might tell you to stop taking this medication. Let your provider know right away if you have any changes in how often you urinate, any blood or foam in your urine, tiredness, dry or itchy skin, muscle cramping, or lower than normal appetite. These might be signs of kidney problems.
Interactions with other medications
- Risk factors: Taking multiple medications
Ranolazine (Ranexa) can interact with several medications. These interactions can affect how well ranolazine (Ranexa) or other medications leave your body, leading to medication buildup in the body and a higher risk of side effects.
To lower your risk of dangerous drug interactions, some medications should be avoided altogether when you're taking ranolazine (Ranexa), including clarithromycin and carbamazepine (Tegretol). Sometimes, the dose of ranolazine (Ranexa) is limited to 500 mg twice daily when it's taken with certain medications, such as diltiazem (Cardizem), verapamil, erythromycin, and fluconazole (Diflucan). Other times, your provider might adjust the dose of your other medications. For example, the dose of the common cholesterol medication simvastatin (Zocor) is limited to 20 mg per day when taken with ranolazine (Ranexa).
This isn't a complete list of medications that interact with ranolazine (Ranexa). Be sure to talk to your provider or pharmacist about all the medications you take to make sure they can manage any interactions with ranolazine (Ranexa).
Ranolazine (Ranexa) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 500mg | 60 tablets | $19.38 | $0.32 |
| 1000mg | 180 tablets | $62.88 | $0.35 |
Typical dosage for Ranolazine (Ranexa)
For the extended-release tablets and oral granules, the typical starting dose is 500 mg by mouth twice a day. Your provider may raise the dose to a maximum of 1,000 mg twice a day, based on how you respond to the medication.
Interactions between Ranolazine (Ranexa) and other drugs
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 this medicine, 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 this medicine 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.
- 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 this medicine 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.
- Abametapir
- Acecainide
- Afatinib
- Alfentanil
- Alfuzosin
- Alprazolam
- Amiodarone
- Amisulpride
- Anagrelide
- Apomorphine
- Aprepitant
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Artemether
- Asenapine
- Astemizole
- Azimilide
- Azithromycin
- Bedaquiline
- Benzhydrocodone
- Berotralstat
- Betrixaban
- Bretylium
- Buprenorphine
- Buserelin
- Capmatinib
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Citalopram
- Clofazimine
- Clozapine
- Codeine
- Conivaptan
- Crizotinib
- Cyclobenzaprine
- Cyclosporine
- Dabigatran Etexilate
- Dabrafenib
- Dasatinib
- Degarelix
- Delamanid
- Deslorelin
- Deutetrabenazine
- Digoxin
- Dihydrocodeine
- Dihydroergotamine
- Diltiazem
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Droperidol
- Efavirenz
- Eliglustat
- Encorafenib
- Entrectinib
- Ergotamine
- Erythromycin
- Escitalopram
- Fentanyl
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Formoterol
- Fosaprepitant
- Foscarnet
- Fosnetupitant
- Fostemsavir
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydrocodone
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Inotuzumab Ozogamicin
- Ivabradine
- Ivosidenib
- Lapatinib
- Lasmiditan
- Lefamulin
- Lemborexant
- Lenvatinib
- Levofloxacin
- Lofexidine
- Lovastatin
- Lumefantrine
- Macimorelin
- Mefloquine
- Meperidine
- Methadone
- Metronidazole
- Mifepristone
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Moxifloxacin
- Nafarelin
- Netupitant
- Nilotinib
- Norfloxacin
- Octreotide
- Ofloxacin
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxycodone
- Ozanimod
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Pentazocine
- Pimavanserin
- Pitolisant
- Pixantrone
- Ponesimod
- Prochlorperazine
- Promethazine
- Propafenone
- Quetiapine
- Quinidine
- Quinine
- Relugolix
- Ribociclib
- Rimegepant
- Selpercatinib
- Sematilide
- Sertraline
- Sevoflurane
- Simeprevir
- Simvastatin
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sorafenib
- Sotalol
- Sufentanil
- Sulpiride
- Sunitinib
- Tacrolimus
- Tedisamil
- Telithromycin
- Tetrabenazine
- Topotecan
- Toremifene
- Tramadol
- Trazodone
- Triclabendazole
- Trifluoperazine
- Triptorelin
- Ubrogepant
- Vandetanib
- Vardenafil
- Vemurafenib
- Venetoclax
- Verapamil
- Vincristine
- Vincristine Sulfate Liposome
- Vinflunine
- Voclosporin
- Voriconazole
- Zuclopenthixol
Using this medicine 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.
How much does Ranolazine (Ranexa) cost?
$19.38
Ranolazine (Ranexa) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ranolazine (Ranexa) will not be safe for you to take.
- Taking certain medications that interact with ranolazine (Ranexa)
- Liver cirrhosis
What are alternatives to Ranolazine (Ranexa)?
Ranolazine (Ranexa) images
