Update on ranolazine in the management of angina.

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Codolosa JN, Acharjee S, Figueredo VM

Update on ranolazine in the management of angina.

Vasc Health Risk Manag. 2014 Jun 24;10:353-62. doi: 10.2147/VHRM.S40477. eCollection 2014.

PubMed ID

25028555 [ View in PubMed

]

Abstract

Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life.

DrugBank Data that Cites this Article

Drugs

Ranolazine

Drug Enzymes

Drug	Enzyme	Kind	Organism	Pharmacological Action	Actions
Ranolazine	Cytochrome P450 2D6	Protein	Humans	No	Substrate Inhibitor	Details
Ranolazine	Cytochrome P450 3A4	Protein	Humans	No	Substrate Inhibitor	Details

Drug Transporters

Drug	Transporter	Kind	Organism	Pharmacological Action	Actions
Ranolazine	P-glycoprotein 1	Protein	Humans	No	Substrate Inhibitor	Details

Drug Interactions

Drugs	Interaction
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Acebutolol Ranolazine	The serum concentration of Acebutolol can be increased when it is combined with Ranolazine.
Almotriptan Ranolazine	The serum concentration of Almotriptan can be increased when it is combined with Ranolazine.
Alogliptin Ranolazine	The serum concentration of Alogliptin can be increased when it is combined with Ranolazine.
Aminophenazone Ranolazine	The serum concentration of Aminophenazone can be increased when it is combined with Ranolazine.
Amoxapine Ranolazine	The serum concentration of Amoxapine can be increased when it is combined with Ranolazine.