Ranolazine

Summary

Ranolazine is a medication used to treat chest pain. It does this by decreasing sodium and calcium levels inside the myocardial cells, which leads to decreased cardiac oxygen demand.

One side effect of ranolazine is a prolonged QT interval, which puts the patient at risk of developing other cardiac arrhythmias.

Patients taking ranolazine should be advised to avoid grapefruit juice and quinidine.

Key Points

• Ranolazine
  • Mechanism
    • Decreases sodium and calcium in the myocardial cells
    • Lowers cardiac oxygen demand
  • Clinical Use
    • Treats angina (chest pain)
      • Can be used to treat chronic, stable angina, and is often combined with a beta blocker or a nitrate
  • Side Effects
    • Causes QT prolongation
      • Increases risk for torsades de pointes, a life-threatening arrhythmia
  • Nursing Considerations
    • Avoid grapefruit juice
      • Grapefruit juice interferes with how ranolazine is metabolized in the body
      • A buildup of ranolazine in the blood can lead to an increase of side effects
    • Avoid quinidine
      • Ranolazine and quinidine both prolong the QT interval, so the combination of these drugs puts the patient at risk of developing a dangerous heart rhythm