Ranolazine
Ranolazine is an antianginal medication used to treat chronic angina (chest pain). Unlike many other heart medications, it provides relief without reducing heart rate or blood pressure. Its exact mechanism of action remains not fully determined.
A second-line antianginal medication for chronic angina that works independently of heart rate and blood pressure effects.
Key facts at a glance
- ATC
- C01EB18
- RxNorm
- 35829
- Generic
- Ranolazine
- Class
- atc-c01
- Brands
- Aspruzyo, Ranexa
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
13 groupspregnancy
first trimesteravoid if possible
use only if potential benefits outweigh potential risks to fetus
regular fetal monitoring recommended
Use with caution and monitor for adverse effects.
pregnancy
second trimesteravoid if possible
continue only if benefits outweigh risks
fetal growth monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
discontinue before delivery if possible
fetal monitoring and assessment for preterm labor
Use with caution and monitor for adverse effects.
lactation
breastfeedinguse with caution
decision to breastfeed should consider infant exposure and maternal need for drug
monitor infant for excessive sleepiness or feeding problems
Use with caution and monitor for adverse effects.
geriatric
elderly 65 plusstart at lower end of dosing range
use lower initial dose and titrate slowly, monitor renal function
regular monitoring of renal function and blood pressure
Use with caution and monitor for adverse effects.
pediatric_age
children under 18not established
not recommended, safety and efficacy not established in pediatric patients
not applicable
renal_impairment
mildno adjustment needed
no dose adjustment required for mild renal impairment
periodic renal function monitoring
renal_impairment
moderateuse with caution
use cautiously, consider dose reduction in some patients
regular monitoring of renal function
Use with caution and monitor for adverse effects.
renal_impairment
severeavoid use
not recommended in patients with severe renal impairment (CrCl <30 mL/min)
renal function monitoring if used
Use of this medication in this population requires careful consideration of risks and benefits.
hepatic_impairment
mildno adjustment needed
use with caution, no specific dose adjustment
monitor for adverse effects
Use with caution and monitor for adverse effects.
hepatic_impairment
moderatedose reduction recommended
reduce maximum daily dose to 750mg, use with caution
regular liver function monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
severecontraindicated
contraindicated in severe hepatic impairment
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
alcohol_users
chronic heavy alcoholavoid or limit alcohol
avoid concomitant alcohol consumption, may increase risk of hypotension and dizziness
monitor blood pressure, watch for orthostatic symptoms
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
FDA approval for Ranexa (ranolazine) for chronic angina
Drug class
ATC code C01EB02 - other antianginal agents
Primary indication
Treatment of chronic angina pectoris
Mechanism of action
Reduces sodium influx during ischemia reducing diastolic tension
Treatment of chronic angina as add-on therapy when first-line antianginal medications are insufficient or not tolerated.
Anti-ischemic and antianginal effects occur without reducing heart rate or blood pressure. The exact molecular mechanism has not been fully determined, but it does not affect the rate-pressure product.
Used as second-line therapy, typically added to standard antianginal treatments. The precise mechanism of action remains undetermined, making it a unique option among cardiovascular drugs. Safety monitoring and appropriate patient selection are essential.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy