Ranolazine (patient information)

# Why is this medication prescribed
Ranolazine is used with other medications to treat angina (chest pain or pressure that is felt when the heart does not get enough oxygen) that is a symptom of an ongoing condition. Ranolazine is used to treat people who still experience angina even when they take other medications to treat the condition. Ranolazine may prevent episodes of angina, but it cannot be used to relieve an episode of angina that has already begun. Ranolazine is in a class of medications called anti-ischemics. The exact way that ranolazine works is not known at this time.

# How should this medicine be used
Ranolazine comes as an extended-release (long-acting) tablet to take by mouth. It is usually taken with or without food two times a day. Take ranolazine at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ranolazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the tablets whole; do not break, chew, or crush them.
Your doctor will probably start you on a low dose of ranolazine and gradually increase your dose.
Do not take ranolazine to treat a sudden attack of angina. Your doctor will tell you what you should do if you experience an attack of angina. Make sure that you understand these directions.
Ranolazine may help to control your condition but will not cure it. Continue to take ranolazine even if you feel well. Do not stop taking ranolazine without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking ranolazine:
- tell your doctor and pharmacist if you are allergic to ranolazine, any other medications, or any of the ingredients in ranolazine tablets. Ask your pharmacist for a list of the ingredients.
- tell your doctor if you are taking any of the following medications: certain antibiotics such as clarithromycin (Biaxin, in Prevpac),erythromycin (E.E.S., E-Mycin, Erythrocin), moxifloxacin (Avelox), sparfloxacin (Zagam) (not available in the United States) and troleandomycin (TAO); certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend);certain antipsychotics (medications to treat mental illness) including thioridazine (Mellaril) and ziprasidone (Geodon); cisapride (Propulsid) (not available in the United States);diltiazem (Cardizem, Tiazac, Dilacor); certain medications to treat human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); medications for irregular heartbeat such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Procanbid, Pronestyl), quinidine (Quinidex), and sotalol (Betapace);pimozide (Orap); and verapamil (Calan, Covera, Isoptin, Verelan). Your doctor may tell you not to take ranolazine if you are taking one or more of these medications.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);cyclosporine (Neoral, Sandimmune); digoxin (Lanoxicaps, Lanoxin); and simvastatin (in Vytorin, Zocor). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with ranolazine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list or the list above.
- tell your doctor if you have or have ever had a prolonged QT interval (a rare heart problem that may cause fainting or irregular heartbeat) or liver disease. Your doctor may tell you that you should not take ranolazine.
- tell your doctor if anyone in your family has or has ever had a prolonged QT interval and if you or anyone in your family has or has ever had a fast, slow, or irregular heartbeat; an abnormal electrocardiogram (EKG, ECG, heart rhythm test), or low levels of potassium in the blood. Also tell your doctor if you have or have ever had kidneydisease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ranolazine, call your doctor. You should not breast-feed while taking ranolazine.
- you should know that ranolazine may make you dizzy and lightheaded. Do not drive a car, operate machinery, or participate in activities requiring mental alertness and coordination until you know how this medication affects you.

# What special dietary instructions should I follow
Do not drink grapefruit juice or eat grapefruit products while taking this medication.

# What should I do if I forget a dose
Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Mild side effects
Ranolazine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nausea
- constipation
- headache
- dizziness

## Severe side effects
Some side effects can be serious. If you experience either of these symptoms, call your doctor immediately:
- fast, pounding, or irregular heartbeat
- fainting
Ranolazine may cause prolonged QT interval, a serious or life-threatening condition. Talk to your doctor about the risks of taking this medication.
Ranolazine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- nausea
- vomiting
- dizziness
- confusion
- double vision
- pain, burning, numbness, or tingling in any part of the body
- fainting
- loss of consciousness

# What other information should I know
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Ranexa