Ranolazine
Pronunciation: (ra-NO-la-zeen).
- Generic name
- ranolazine
- Brand names
- Ranozine, Ranexa, Ranolaz, Ranozex
- Drug class
- Cardio-Metabolic
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What ranolazine is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how ranolazine works
Ranolazine inhibits the late phase of the inward sodium current (late INa) in cardiac myocytes during repolarization. This reduces intracellular sodium and calcium overload, improving myocardial relaxation and reducing ventricular wall tension and oxygen consumption. Unlike traditional antianginals, ranolazine does not significantly affect heart rate or blood pressure. (1)
What ranolazine is used for
Chronic angina
Chronic angina (1)
Coronary artery disease
Coronary artery disease (1)
Before taking ranolazine
Do not take / not appropriate for
- Contraindicated in patients with severe hepatic impairment, pre-existing QT prolongation, or those taking strong CYP3A inhibitors. (Contraindication) (1)
Tell your clinician about
(1)How to take ranolazine
- General Instructions: Take ranolazine exactly as prescribed by your doctor. Do not increase your dose or take it more often than directed.. Adult Dosing: The usual starting dose is 500 mg twice daily. Your doctor may increase the dose to a maximum of 1000 mg twice daily, depending on your response and tolerance.. Pediatric Dosing: Ranolazine is not recommended for use in children or adolescents under 18 years of age.. Administration: Swallow the extended-release tablet whole with a glass of water. Do not crush, break, or chew the tablet.. When To Seek Review: Do not stop taking ranolazine without consulting your doctor, even if you feel well. Stopping suddenly may worsen your condition.. Storage: Store at room temperature (20°C to 25°C/68°F to 77°F), away from moisture and heat. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at the same time.
Overdose
In case of overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms may include nausea, vomiting, dizziness, fainting, or irregular heartbeat. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Constipation
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
QT prolongation
Incidence: Reported in the clinician-authored database; frequency not established
Bradycardia
Incidence: Reported in the clinician-authored database; frequency not established
Syncope
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
May cause QT interval prolongation and serious arrhythmias — serious
Symptoms: May cause QT interval prolongation and serious arrhythmias. Use with caution in patients with moderate liver or kidney impairment. Not recommended for use in pregnancy or breastfeeding unless clearly needed. May interact with many other medications; always inform your healthcare provider of all drugs you are taking. Not for use in acute angina attacks.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with severe hepatic impairment, pre-existing QT prolongation, or those taking strong CYP3A inhibitors. Use caution in moderate hepatic or renal impairment, elderly patients, and those with a history of arrhythmias.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Ranolazine can interact with several medications, including strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin), CYP3A inducers (e.g., rifampin, phenytoin), and drugs that prolong the QT interval (e.g., certain antiarrhythmics, antipsychotics). Always inform your healthcare provider about all prescription, over-the-counter, and herbal products you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
The FDA label states there are no adequate data on the developmental risk associated with ranolazine use in pregnant women; animal studies showed adverse developmental effects only at maternally toxic doses. Discuss use during pregnancy with the prescriber. (1)
Breastfeeding
The FDA label states there is no information on the presence of ranolazine in human milk, its effects on the breastfed infant, or on milk production. Discuss breastfeeding with the prescriber. (1)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children (1)
Renal_impairment
Renal impairment: plasma ranolazine levels increase by up to ~50% across varying degrees of renal impairment; no specific numeric dose-adjustment table is given, so use with caution and clinical monitoring. Hepatic impairment: Ranexa is contraindicated in patients with clinically significant hepatic impairment — plasma concentrations increase by approximately 30% with mild impairment and 60% with moderate impairment. (1)
Hepatic_impairment
Renal impairment: plasma ranolazine levels increase by up to ~50% across varying degrees of renal impairment; no specific numeric dose-adjustment table is given, so use with caution and clinical monitoring. Hepatic impairment: Ranexa is contraindicated in patients with clinically significant hepatic impairment — plasma concentrations increase by approximately 30% with mild impairment and 60% with moderate impairment. (1)
Monitoring
(1)Storage
Store at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F), per the FDA label. Keep out of reach of children.
Study the drug class: Sinus node and metabolic cardiac agents
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Chronic angina
Dose summary: Initial dose of 500 mg orally twice daily, may be increased to 1000 mg twice daily based on clinical response.
Renal context: In studies across varying degrees of renal impairment, ranolazine plasma levels increased by up to approximately 50%. The FDA label does not give a specific numeric dose-adjustment figure for renal impairment alone (heart failure itself had no significant effect on ranolazine pharmacokinetics), so the prescriber should individualise dosing and monitor closely in patients with renal impairment, particularly when combined with other risk factors. (1)
Frequently asked questions
What is ranolazine used for?
Ranolazine is used to treat chronic angina (chest pain) in adults who have not responded adequately to other antianginal medications.
Can ranolazine be used for acute chest pain?
No, ranolazine is not intended for the immediate relief of acute angina attacks. Use your fast-acting nitroglycerin for sudden chest pain.
How long does it take for ranolazine to work?
Ranolazine may start to reduce the frequency of angina attacks within a few days, but full benefits may take several weeks.
Can I drink alcohol while taking ranolazine?
Alcohol may increase the risk of certain side effects such as dizziness. Discuss alcohol use with your doctor before starting ranolazine.
What should I do if I experience dizziness while taking ranolazine?
If you feel dizzy, sit or lie down until the feeling passes. Avoid driving or operating machinery until you know how ranolazine affects you.
Is ranolazine safe during pregnancy or breastfeeding?
Ranolazine should only be used during pregnancy or breastfeeding if clearly needed and prescribed by your doctor. Safety data is limited.
Can ranolazine be taken with other heart medications?
Ranolazine is often used with other heart medications, but drug interactions are possible. Always inform your healthcare provider about all medicines you are taking.
What happens if I take too much Ranolazine?
Taking too much Ranolazine can lead to severe symptoms such as dizziness, nausea, vomiting, and potentially life-threatening heart rhythm abnormalities. If you suspect an overdose, it is crucial to seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat. Contact emergency services or go to the nearest emergency room without delay.
Is Ranolazine safe during pregnancy?
Ranolazine's pregnancy category requires careful consideration. The safety of Ranolazine during pregnancy has not been definitively established, and it should only be used if the potential benefits outweigh the potential risks to the fetus. It is essential to consult your doctor immediately if you are pregnant, planning to become pregnant, or breastfeeding, to discuss the risks and benefits of continuing Ranolazine.
What is the mechanism of action of ranolazine?
Ranolazine inhibits the late phase of the inward sodium current (late INa) in cardiac myocytes during repolarization. This reduces intracellular sodium and calcium overload, improving myocardial relaxation and reducing ventricular wall tension and oxygen consumption. Unlike traditional antianginals, ranolazine does not significantly affect heart rate or blood pressure. (1)
What is the generic name of Ranolazine?
The generic name is ranolazine. It is sold under brand names including Ranozine, Ranexa, Ranolaz, Ranozex.
What class of drug is ranolazine?
Ranolazine is classed as: Cardio-Metabolic.
References
- Ranolazine — Prescribing InformationMedGuideGlobal · United States · accessed 2026-08-03 · source 1
- RANEXA (ranolazine) FDA-approved prescribing informationU.S. DailyMed (NIH) · United States · accessed 2026-08-07 · source 2
- RANOLAZINE TABLET, EXTENDED RELEASE [UMEDICA LABORATORIES USA INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Ranolazine — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Ranolazine — FDA approval record (Drugs@FDA ANDA210188)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- ranolazine — RxNorm normalized drug concept (RXCUI 35829)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient ranolazine names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- ASPRUZYO SPRINKLE1000 mg · sun pharmaceutical industries, inc.