2.6.3 Ranolazine


Reserve [For information only, not a NI Formulary Choice]

Ranolazine (Ranexa®) tablets m/r 375mg, 500mg, 750mg [Consultant cardiologist initiation only]Dose:
Initially 375mg twice daily, increased if necessary after 2-4 weeks to 500mg twice daily

Please note, in practice, 375mg twice daily is often used as a maintenance dose. Higher doses may lead to QT prolongation (exercise caution with doses greater than 500mg twice daily)

Prescribing Notes

  • Ranolazine may be useful (under consultant cardiologist advice only) for patients intolerant of other anti-anginal treatments, especially those with low BP and/or low heart rate


  • Caution in patients with borderline renal function (avoid if eGFR less than 30mL/minute/1.73m2)
  • Ranolazine is largely metabolised by the CYP3A4 system and there is a potential for serious drug interactions (see BNF)