Your doctor may have prescribed a medication for your occasional chest pain (angina). The name of that medication may be Ranolazine. This is a special medicine for the heart that is used to control long-term chest pain. So today, let's talk briefly about this medicine called Ranolazine, how to use it, what to be careful about, and the possible side effects.
What kind of medicine is Ranolazine?
Simply put, Ranolazine is a medication that is used to help protect your heart health. Specifically, it is used to treat chest pain that lasts for a long time, a condition medically known as ``Chronic Angina.''
But this is very important: This medicine will not provide immediate relief for a sudden, severe chest pain (Acute Angina attack). Your doctor may have prescribed another medicine (for example, a GTN pill) for such an emergency. Ranolazine is only a medicine that is given for long-term control of the disease.
This medicine may come under various brand names in Sri Lanka and abroad. `Ranexa` is one such well-known brand name.
What should I tell the doctor before starting this medication?
For your safety, it is essential that you inform your doctor about your complete health history before starting this medication. Be sure to tell them about any of the following conditions, especially if you have them.
- Other heart conditions.
- Irregular heartbeat .
- Kidney disease .
- Liver disease.
- If you have low levels of potassium or magnesium in your blood.
- If you have allergies to ranolazine or any other medicine, food, or dye.
- If you are pregnant or trying to get pregnant .
- If you are a breastfeeding mother .
Based on this information, your doctor will decide whether this medication is right for you or whether the dosage needs to be changed.
How should I use this medicine?
To get the most out of a medicine, you need to use it as directed.
- How to swallow: Swallow this tablet whole with a glass of water. Never break, crush, or chew this tablet. These are specially formulated to release the medicine into the body over time (Extended-Release). Therefore, it is very important to swallow it whole.
- Time of taking: Try to take your medicine at the same time every day , as prescribed by your doctor. This will help maintain consistent levels of the medicine in your body.
- With or without food: This medication can be taken before or after meals. However, some people may experience stomach upset if taken with a meal.
- Stopping: Do not stop taking this medicine unless your doctor tells you to.
Special warnings
Do not take this medicine with grapefruit juice. Grapefruit juice can affect the way this medicine works in the body.
What to do if you miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What if I take too much medicine?
If you think you have taken too much of this medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other medications that may interact with Ranolazine
This is very important. Ranolazine can interact with many other medications, so you should tell your doctor about all the medications you are taking (including vitamins, herbal remedies, and supplements).
You can get a good idea about this from the two tables below.
| Never take Ranolazine with this medicine. | |
|---|---|
| Drug category | Examples |
| Some antibiotics | Clarithromycin, Rifampin |
| Medicine for fungal infections | Itraconazole, Ketoconazole |
| Antiviral drugs for HIV or Hepatitis | (Ask your doctor) |
| Some medications for epilepsy (Seizure) | Carbamazepine, Phenytoin |
| St. John's Wort (herbal extract) | Avoid using this. |
| Be especially careful if you take Ranolazine with this medicine. | |
|---|---|
| Drug type/category | |
| Some cholesterol-lowering medications (e.g. Simvastatin, Atorvastatin) | |
| Medication for depression or anxiety | |
| Digoxin, Diltiazem, Verapamil (other medications for heart disease) | |
| Metformin (a medicine for diabetes) | |
| Cyclosporine, Tacrolimus (immune system suppressors) | |
These lists are not complete. For your safety, tell your doctor about all medications you are taking.
What side effects might I experience?
Like any medicine, Ranolazine can cause side effects in some people. Some of these can be serious, so it's important to be aware of them.
| Side effect | What to do? |
|---|---|
| Side effects that require immediate medical attention | |
| Allergic reactions: skin rash, itching, swelling of the face, lips, tongue | Inform your doctor immediately or go to a hospital. |
| Heartbeat changes: fast or irregular heartbeat, chest pain, shortness of breath, severe dizziness | |
| Low blood pressure: dizziness, fainting, blurred vision | |
| Swelling of the ankles, hands, or feet | |
| Tremors or numbness in the limbs | |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Dizziness | If these persist or are bothersome, tell your doctor. |
| Headache | |
| Nausea | |
| Constipation | |
How do you protect your medicine?
- Keep this medicine out of the reach of children and pets .
- Store at room temperature (around 25°C), in a dry place.
- Do not use expired medications. Dispose of them properly. It is generally a good idea to mix unwanted medications with something like used coffee grounds or soil before putting them in the trash, seal them in a bag, and dispose of them. If you are unsure about this, ask your doctor.
Take-Home Message
- Ranolazine is a medication used to control long-term chest pain (Chronic Angina), not a medication that provides immediate relief from sudden chest pain.
- Swallow this tablet whole without breaking, crushing, or chewing.
- Avoid taking this medicine with grapefruit juice altogether.
- Be sure to tell your doctor about all other medications you are taking.
- Seek immediate medical attention if you experience changes in your heartbeat, severe dizziness, or allergic symptoms.
- Never stop taking medication without your doctor's advice.
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