Ranolazine (ra-NOE-la-zeen)

Treats chronic angina (chest pain).

Brand Name(s):

Ranexa

When This Medicine Should Not Be Used:

How to Use This Medicine:

Granule, Long Acting Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Extended-release granules:
  • With soft food: Sprinkle the granules on one tablespoonful of soft food (including applesauce or yogurt) and swallow it right away. Do not crush or chew the granules.
  • Nasogastric tube: Add the granules with 50 milliliters (mL) of water into a syringe. Gently shake the mixture for at least 15 seconds, then flush it through the tube right away. Rinse the syringe with 15 mL of water, then flush it through the tube until all of the medicine is washed out.
  • Gastric tube: Add the granules with 30 mL of water into a syringe. Gently shake the mixture for at least 15 seconds, then flush it through the tube right away. Rinse the syringe with 20 mL of water, then flush it through the tube. Rinse it again with 15 mL of water until all of the medicine is washed out.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with carbamazepine, clarithromycin, itraconazole, ketoconazole, nefazodone, phenobarbital, phenytoin, rifabutin, rifampin, rifapentine, medicines to treat HIV or AIDS (including indinavir, lopinavir, nelfinavir, ritonavir, saquinavir), or St John's wort.
• Some foods and medicines can affect how ranolazine works. Tell your doctor if you are using any of the following:
  • Cyclosporine, digoxin, diltiazem, erythromycin, fluconazole, lovastatin, metformin, simvastatin, sirolimus, tacrolimus, verapamil
  • Medicine to treat mental health problems (including TCAs)
  • Medicine to treat heart rhythm problems (including amiodarone, dofetilide, quinidine, sotalol)
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, or heart rhythm problems.
• This medicine may cause the following problems:
  • Heart rhythm problem (including QT prolongation)
  • Kidney problems
• Do not use this medicine to treat a sudden onset of chest pain.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate, lower back or side pain
• Fainting, dizziness, or lightheadedness
• Fast, pounding, or uneven heartbeat
• Rapid weight gain, swelling of your hands, ankles, or feet

If you notice these less serious side effects, talk with your doctor:

• Constipation, nausea
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088