Ranolazine

Amber-G

Brand Name(s):Ranexa, Latixa

Indication:All licensed indications

Rationale:

Considered:Apr-11

Review Date:Jul-23

Comments:
Ranolazine should only be initiated on the advice of a Consultant Cardiologist.
Ranolazine is a substrate and a moderate to potent inhibitor of CYP3A4 check the BNF (www.bnf.org.uk) for interactions before prescribing. It is contra-indicated in patients with severe renal impairment where creatinine clearance is 30ml/min or CKD stage 4.
The mechanism of action is largely unknown, although it is known to selectively inhibit late inward sodium current transmission. Anti-anginal effects are independent of heart rate, blood pressure or vasodilatation.
Advice for monitoring
Renal function should be checked annually, or where there is a suspicion of deterioration, as ranolazine is contra-indicated in those with severe renal impairment where eGFR is less than 30ml/min (CKD4/5).

Note – dosage adjustment in the BNF is expressed in terms of eGFR: that in the SPC is expressed in terms of creatinine clearance.

July 2013