Ranolazine (Ranexa) is an anti-anginal medication used to treat chronic chest pain (angina) in patients with coronary artery disease.
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Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Ranolazine (Ranexa) reduces chronic angina symptoms through a mechanism distinct from traditional anti-anginals (beta-blockers, nitrates, calcium channel blockers) — it inhibits the late sodium current in cardiac cells, reducing calcium overload and improving diastolic relaxation, without significantly affecting heart rate or blood pressure. It is FDA-approved for the treatment of chronic angina, typically used in combination with other anti-anginal therapies when symptoms are not adequately controlled. Ranolazine can prolong the QT interval and has significant interactions with strong CYP3A inhibitors/inducers, so a review of concurrent medications is important before starting therapy.
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