Ranolazine
(Redirected from Ranexa)
| Drug monograph · NCLEX study reference | |
| Trade names | Ranexa |
|---|---|
| Therapeutic class | Antianginal |
| Pharmacologic class | Late sodium current inhibitor |
| Onset / peak / duration | ER peak 2 to 5 hours; dosed twice daily. |
| Half-life / level | Half-life about 7 hours; no routine level. |
| Routes | PO (oral) |
| High-alert (ISMP) | No |
| Black box warning | None |
| Antidote / reversal | Supportive care. |
| Pregnancy / lactation | Use only if clearly needed. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Ranolazine (brand name Ranexa) — Antianginal; Late sodium current inhibitor.
Identification
- Therapeutic class: Antianginal.
- Pharmacologic class: Late sodium current inhibitor.
Pharmacology
- Mechanism of action: Inhibits the late sodium current in cardiac cells, improving myocardial relaxation and oxygen use without major effects on heart rate or blood pressure.
- Onset / peak / duration: ER peak 2 to 5 hours; dosed twice daily.
- Half-life / therapeutic level: Half-life about 7 hours; no routine level.
Clinical use
- Indications: Chronic stable angina, usually as add-on therapy.
- Usual dose, route, frequency: 500 to 1,000 mg PO twice daily.
- Maximum dose / adjustments: Max 1,000 mg twice daily; reduce or avoid with strong CYP3A4 inhibitors.
Safety
- Contraindications: Hepatic cirrhosis, strong CYP3A4 inhibitors or inducers, QT-prolonging conditions.
- Black box warning: None.
- Interactions: CYP3A4 inhibitors, simvastatin (raises level), digoxin, grapefruit juice (food), QT-prolonging drugs.
- Pregnancy / lactation: Use only if clearly needed.
- High-alert: No.
Adverse effects
- Common side effects: Dizziness, headache, constipation, nausea.
- Serious effects to report: QT prolongation, syncope.
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: ECG, blood pressure, hepatic and renal function.
- Interventions during therapy: Review for interacting drugs; do not crush ER.
- Monitor: ECG and QT, blood pressure.
- Evaluation / expected outcome: Reduced angina frequency.
Patient teaching
- Patient teaching: This prevents angina and does not relieve acute attacks.
- Notify provider if: Fainting, palpitations.
- Administration tips: Swallow ER whole; avoid grapefruit.