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Side Effects of Ranolazine (Ranexa)


Description: Ranolazine, commonly known under its trade name Ranexa, is a drug that inhibits sodium influxes in the heart. The drug is commonly used to treat Angina and can be used as an adjunct to a number of other cardiovascular drugs including ACE inhibitors, beta blockers and calcium channel blockers. Ranexa has anti-anginal effects but how it works in the body is currently unknown. While it does have effects altering sodium levels in heart cells, this does not fully explain its anti-anginal effects.

Common Side Effects

As Ranexa has a number of possible effects on heart cells, and an unknown method of action, it is associated with a number of side effects. According to the Food and Drug Administration, common side effects of ranolazine according to the Ranexa label as reported by the FDA include (occur in more than 1% of patients taking Ranexa):

  • Constipation
  • Nausea
  • Vomiting
  • Dizziness
  • Headache
  • Asthenia (lack of energy)
  • Less Common Side Effects

    Some more uncommon side effects according to the Ranexa label include (occur in less than 1% of patients taking Ranexa):

  • Abdominal pain
  • Dry mouth
  • Dyspepsia (indigestion)
  • Flatulence (excessive gas)
  • Stomach discomfort
  • Pancreatitis (inflammation of the pancreas – can cause patient to vomit)
  • Erosive duodenitis (inflammation of the intestines)
  • Oral hypoaesthesia (reduced sense of touch in the mouth)
  • Lethargy
  • Syncope (fainting)
  • Somnolence (sleepiness)
  • Tremor
  • Postural dizziness
  • Paresthesia (pins and needles)
  • Vertigo
  • Tinnitus
  • Amnesia
  • Decreased levels of consciousness
  • Loss of consciousness
  • Gait disturbance (issues with walking)
  • Fatigue
  • Peripheral edema (swelling of ankles etc)
  • Anorexia
  • Appetite decrease
  • Dehydration
  • Loss of weight
  • Anxiety
  • Insomnia
  • Confusion
  • Hallucination
  • Hot flushes
  • Hypotension (low blood pressure)
  • Peripheral coldness
  • Orthostatic hypotension (head rush when moving from lying to standing position)
  • Dyspnea (difficulty breathing)
  • Cough
  • Epistaxis
  • Blurred vision
  • Visual disturbance
  • Diplopia (double vision)
  • Hyperhidrosis (excessive sweating)
  • Understand Your Risk for Side Effects with the Rxight® Pharmacogenetic Testing Program

    MD Labs provides the most comprehensive CLIA-certified pharmacogenetic testing program available, Rxight®, which sequences 18 genes to establish how a patients is likely to react to hundreds of drugs (including Ranexa) across 50 clinically significant medication classes. All that is required for testing is a simple cheek swab of your DNA at a participating pharmacy, after which you will receive a comprehensive review of your results with a pharmacist with expertise in pharmacogenetics.

    How Does Pharmacogenetic Testing Work?

    This inter-patient variability may be caused by differences in patients genetics. Individual differences in the chemicals in the body that metabolize Ranexa may cause adverse effects in some patients and identifying these gene variants in individuals with PGx testing can therefore aid in clinical decision making. Prescribers can identify poor metabolizers and closely monitor for side effects. They may also adjust the dose of the drug that is prescribed, or find a safer alternative if needed.


    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Read more about Rxight® pharmacogenetics