Introduction
Ranozex 500 is a medicine used for the management of angina (heart-related chest pain). It helps to prevent new attacks of angina, but it does not stop an acute attack, once it has started. It relieves chest pain by making the heart work more efficiently.
Ranozex 500 should be taken in the dose as advised by your doctor, at the same time each day. It should be taken with food to avoid stomach upset. Your doctor will decide how often you should take this medicine. This may change from time to time depending on how well it is working. You should take this medicine regularly to get the most benefit, even if you feel fine. It is preventing future harm. If you stop taking it, your chest pain may come back.
You can improve the health of your heart by making some lifestyle changes such as quitting smoking, cutting down on alcohol, eating well, taking regular exercise and managing stress. Some common side effects of this medicine include nausea, vomiting, headache, dizziness, constipation, and weakness. Talk to your doctor if these bother you or do not go away.
This is not suitable for some people. Tell your doctor if you are suffering from any liver or kidney problems. Also let your doctor know all other medications you are using as some may affect, or be affected by this medicine. This medicine is not usually recommended during pregnancy or breastfeeding.
Uses of Ranozex 500
- Angina (heart-related chest pain)
Side effects of Ranozex 500
Common
- Nausea
- Vomiting
- Headache
- Dizziness
- Constipation
- Weakness
How to use Ranozex 500
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ranozex 500 is to be taken with food.
How Ranozex 500 works
Ranozex 500 is an anti-anginal medication. It works by decreasing the oxygen requirement of the heart by relaxing heart muscle.
What if you forget to take Ranozex 500?
If you miss a dose of Ranozex 500, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Administration
May be taken with or without food.
Adult Dose
Oral
Chronic angina
500 mg PO BID initially; may increase to 1,000 mg PO BID, if needed
Hepatic Impairment: Mild: Dose titration needed. Moderate to severe: Contraindicated.
Renal Dose
Renal Impairment
Mild to moderate (CrCl 30-80 mL/min): Dose titration needed. Severe (CrCl <30 mL/min): Contraindicated.
Contraindication
Taking strong inhibitors of CYP3A (e.g., ketoconazole, clarithromycin, nelfinavir) Taking inducers of CYP3A (e.g., phenobarbital, rifampicin)Significant hepatic impairment
Mode of Action
Ranolazine exert its antianginal and anti-ischaemic effects through concentration-, voltage-, and frequency-dependent inhibition of the late Na current and other cardiac ion channels and transporters. It may decrease the magnitude of the late Na current resulting in a net reduction in intracellular Na concentrations, reversal of Ca overload, restoration of ventricular pump function, and prevention of ischaemia-induced arrhythmias. Its antianginal effects are not dependent upon reductions in heart rate or BP and QT interval prolongation effect is caused by inhibition of rapid delayed rectifier K current (IKr), which prolongs the ventricular action potential.
Precaution
Heart rhythm problems (e.g., bradycardia, QT prolongation, ventricular tachycardia), liver problems, certain uncorrected mineral imbalances (low potassium/magnesium levels), severe kidney problems.
Lactation: Unknown if excreted in breast milk; discontinue or do not nurse
Side Effect
>10%
Dizziness (5-13%)
1-10%
Nausea (4-9%),Constipation (5-8%),Headache (3-6%),Syncope (3%)
Frequency Not Defined
Palpitations,Bradycardia,Peripheral edema,Prolonged QT interval,Abdominal pain,Dry mouth,Dyspepsia,Anorexia,Vomiting,Hematuria,Dyspnea,Tinnitus,Vertigo,Blurred vision,Vasovagal syncope,Confusional state,Hematuria,Hyperhidrosis
Interaction
Increased plasma levels w/ moderate CYP3A4 inhibitors (e.g. diltiazem, fluconazole, erythromycin), P-glycoprotein inhibitors (e.g. verapamil, ciclosporin) and CYP2D6 inhibitors (e.g. paroxetine). May increase plasma digoxin concentrations. May increase risk of rhabdomyolysis w/ simvastatin. May increase plasma concentrations of atorvastatin, other statins (e.g. lovastatin) and CYP3A4 substrates w/ narrow therapeutic range (e.g. tacrolimus, sirolimus, everolimus). May increase plasma exposure of metformin. Increased risk of ventricular arrhythmias w/ other drugs that prolong QT interval (e.g. terfenadine, astemizole, mizolastine).
Potentially Fatal: Increased plasma concentrations leading to increased adverse effects w/ CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, HIV protease inhibitors, clarithromycin, telithromycin, nefazodone). Decreased plasma concentration w/ CYP3A4 inducers (e.g. rifampicin, phenytoin, phenobarbital, carbamazepine). Increased risk of QT interval prolongation w/ class 1A (e.g. quinidine) or class III (e.g. dofetilide, sotalol) antiarrhythmics other than amiodarone.