1 What is Ranexa?

Brand: Ranexa

Generic: Ranolazine

Ranexa is a prescription-only medicine used together with other medicines, such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, or nitrates to treat chronic angina (chest pain). It is available as an extended-release tablet.

2 What to Know Before Using

Before using Ranexa, you must know all about the risks and complications associated with it. Together with your doctor, you can decide whether the medication will do you more goods than the harms.

Here are some factors to be considered before deciding to use this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Safety and efficacy of ranolazine in children have not been studied extensively. Consult your child’s doctor before using ranolazine.

Geriatric: It may be used in elderly after adjusting the doses.

Pregnancy: It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding: It may be used in a nursing mother after assessing risks and benefits of the use.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. In other cases, even if there is a possible interaction between two medicines your doctor may advise you to take them together after adjusting the dose or issuing precautions.

Here is a list of the medicines which in general are not recommended to be used with ranolazine.

Inform your doctor if you are using any of these medicines:

  • Amprenavir
  • Bepridil
  • Carbamazepine
  • Clarithromycin
  • Clomipramine
  • Desipramine
  • Fosphenytoin
  • Imipramine
  • Itraconazole
  • Nefazodone
  • Nortriptyline
  • Phenobarbital
  • Posaconazole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • St John's Wort
  • Thioridazine
  • Ziprasidone

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

  • Acecainide
  • Afatinib
  • Alfentanil
  • Alfuzosin
  • Amiodarone
  • Anagrelide
  • Apixaban
  • Apomorphine
  • Aprepitant
  • Aripiprazole
  • Artemether
  • Asenapine
  • Astemizole
  • Azithromycin
  • Bretylium
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clozapine
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Dasabuvir
  • Degarelix
  • Delamanid
  • Deslorelin
  • Dihydroergotamine
  • Diltiazem
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxorubicin
  • Droperidol
  • Eliglustat
  • Ergotamine
  • Erythromycin
  • Escitalopram
  • Everolimus
  • Fentanyl
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fosaprepitant
  • Gatifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydroxychloroquine
  • Ibutilide
  • Iloperidone
  • Ivabradine
  • Leuprolide
  • Lovastatin
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mifepristone
  • Morphine
  • Nafarelin
  • Octreotide
  • Paliperidone
  • Panobinostat
  • Paritaprevir
  • Pasireotide
  • Pixantrone
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Quetiapine
  • Quinidine
  • Romidepsin
  • Salmeterol
  • Sematilide
  • Sevoflurane
  • Simeprevir
  • Simvastatin
  • Sodium Phosphate
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Tetrabenazine
  • Tizanidine
  • Tocophersolan
  • Topotecan
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Triptorelin
  • Vardenafil
  • Verapamil
  • Vincristine
  • Voriconazole

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects.

In such cases, you may have to take the adjusted dose or change the frequency of intake.

  • Digoxin
  • Metformin

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe. DO NOT take this medicine with grapefruit juice.

Inform your doctor about the following conditions, if any:

  • Current, or history of abnormal heart rhythms such as QT prolongation
  • Severe kidney impairment: Use cautiously.
  • Liver cirrhosis: Do not use ranolazine.

3 Proper Usage

To use Ranexa properly, you must follow all instructions given by your doctor.

Here are some points to consider:

  • Follow your doctor’s instructions and do not take more, less, more frequently or for a longer duration than recommended.
  • Read the package insert carefully and follow accordingly. If you have any query, consult your doctor.
  • Do not break, or chew the extended-release capsule. Swallow it whole with enough water.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose. The doses of a medicine can differ according to the conditions for which it is being prescribed. Remember your doses can differ. Consult your doctor if you have anything to ask.

For chronic angina (extended-release tablets):

  • Adults: Start with 500 milligrams (mg) two times a day. Then the dose can be adjusted but do not take more than 1000 mg two times a day.
  • Children: Your doctor will decide the use and dose.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose. Do not miss more than a dose. If you do, call your doctor before restarting it.


  • Store in a closed container at room temperature.
  • Keep away from heat, moisture, and direct light.
  • Do not freeze.
  • Keep away from children.
  • Discard any unused or expired medicines.

4 Precautions to Take

Before using Ranexa, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment or have undesirable side effects. Remember:

Do not take ranolazine with:

  • Carbamazepine, clarithromycin, nefazodone, phenobarbital, phenytoin, rifabutin, rifampin, rifapentine
  • Itraconazole, ketoconazole or other similar anti-fungal agents.
  • HIV/AIDS medicines such as indinavir, lopinavir, nelfinavir, ritonavir, saquinavir.
  • St. John's wort.
  • Grapefruit or its juice.

Do not take ranolazine for acute chest pain.

Call your doctor immediately if you have:

  • Rapid heartbeats or tendency to faint while taking ranolazine, indicative of QT prolongation.
  • Restlessness, confusion, decreased urine volume, depression, dizziness, headache, irritability, weakness, abnormal muscle contractions, nausea, rapid weight gain, convulsions, unresponsiveness, swollen face, ankles, or hands, or excessive tiredness. These symptoms could be due to acute kidney failure.

Take special care while driving or using machines, as it might cause dizziness or drowsiness.

Consult your doctor before taking any prescription or nonprescription medicines and herbal or vitamin supplements.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Ranexa.

Consult your doctor immediately if you experience any of the following side effects:

More common: 

Less common:

  • Swollen face and limbs
  • Hearing abnormal sounds such as continuous ringing or buzzing
  • Breathing problems
  • Rapid irregular heartbeat or pulse
  • Head spinning
  • Impaired hearing
  • Abnormal weight gain


  • Abnormal sensory perception of touch
  • Restlessness
  • Bloody urine
  • Blurry vision
  • Sensations of numbness, pinpricks or tingling
  • Chest discomfort
  • Chills
  • Sweating
  • Confusion
  • Decreased urine volume
  • Mental depression
  • Feeling dizzy or fainting
  • Dizziness when changing position
  • Headache
  • Abnormal muscle contractions
  • Nausea
  • Convulsions
  • Tremors
  • Fewer or irregular heartbeat
  • Unresponsiveness
  • Excessive tiredness

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

More common:

  • Problem with bowel emptying

Less common:

  • Dryness of mouth
  • Abdominal pain

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.

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