Side Effects of ranolazine: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major research findings

Ranolazine is a novel antianginal drug that has shown promise in the treatment of cardiovascular disease. 27 It has been shown to be effective in treating chronic stable angina, 20 improving exercise capacity, 27 and reducing the severity of angina. 27 However, it is important to note that Ranolazine can also have side effects, including prolonging the QT interval, which can lead to a potentially fatal arrhythmia called torsades de pointes (TdP). 26 21

Reasons for side effects

The side effects of Ranolazine are mainly due to its effects on the ion channels in the heart. 26 Ranolazine can block these channels, slowing down heart rate or altering the electrical activity of the heart. 26 These effects can lead to arrhythmias and other side effects. 26

Common side effects

Dizziness

Ranolazine has been reported to cause dizziness. 23 20 17 Ranolazine can cause dizziness by blocking ion channels in the heart. 26

Constipation

Ranolazine can cause constipation. 23 20 17 Ranolazine can cause constipation by slowing down the movement of the gastrointestinal tract. 26

Nausea

Ranolazine can cause nausea and vomiting. 23 20 17 Ranolazine can cause nausea by slowing down the movement of the gastrointestinal tract. 26

QT interval prolongation

Ranolazine can prolong the QT interval. 21 26 25 QT interval prolongation increases the risk of torsades de pointes (TdP), a potentially fatal arrhythmia. 21 Ranolazine can prolong the QT interval by blocking ion channels in the heart. 26

Bradycardia

Ranolazine can cause bradycardia (slow heart rate). 7 Ranolazine can cause bradycardia by blocking ion channels in the heart. 26

Hyperkalemia

Ranolazine can cause hyperkalemia (high potassium levels in the blood). 7 Ranolazine can cause hyperkalemia by impairing kidney function. 26

Renal failure

Ranolazine can cause renal failure. 7 Ranolazine can cause renal failure by impairing kidney function. 26

Side effects management

Dizziness

Dizziness from Ranolazine can be reduced by getting up slowly, staying hydrated, and avoiding situations that might trigger dizziness. 26

Constipation

Constipation from Ranolazine can be reduced by increasing fiber intake, staying hydrated, and exercising regularly. 26

Nausea

Nausea from Ranolazine can be reduced by eating small, frequent meals, avoiding fatty or spicy foods, and staying hydrated. 26

QT interval prolongation

QT interval prolongation from Ranolazine can be reduced by lowering the dosage or discontinuing the medication. 26

Bradycardia

Bradycardia from Ranolazine can be reduced by lowering the dosage or discontinuing the medication. 26

Hyperkalemia

Hyperkalemia from Ranolazine can be reduced by discontinuing the medication. 26

Renal failure

Renal failure from Ranolazine can be reduced by discontinuing the medication. 26

Comparison between studies

Similarities

Many studies have shown that Ranolazine is an effective treatment for chronic stable angina. 27 20 12 Studies also indicate that Ranolazine has fewer side effects, such as low blood pressure and heart rate, compared to traditional antianginal medications. 27 20 On the other hand, Ranolazine has been shown to potentially prolong the QT interval, increasing the risk of torsades de pointes (TdP). 21 26 25

Differences

The frequency and severity of side effects from Ranolazine can vary between studies. 26 Additionally, the effectiveness of Ranolazine can also vary between studies. 26

Things to be aware of in real-life application

Ranolazine is an effective treatment for chronic stable angina, but it can prolong the QT interval and increase the risk of torsades de pointes (TdP). 21 26 25 It is crucial to follow your doctor's instructions and take Ranolazine safely. 26

Limitations of current research

There is limited research on the long-term safety and efficacy of Ranolazine. 26 Additionally, while Ranolazine is used in patients with various heart conditions, more research is needed to understand its effects on each specific condition. 26

Future research directions

Further research is needed to understand the long-term safety and efficacy of Ranolazine, as well as its effects on different types of heart diseases. 26

Conclusion

Ranolazine is an effective treatment for chronic stable angina, but it can prolong the QT interval and increase the risk of torsades de pointes (TdP). 21 26 25 It is crucial to follow your doctor's instructions and take Ranolazine safely. 26

Keywords
Benefit Keywords
Angina treatment
Atrial fibrillation prevention
1
Angina relief
Reduced arrhythmic episodes
2
ALS symptom management
3
Reduced arrhythmias
4
Improved RV function
5
Antianginal therapy
Reduced cardiac readmission
6
Angina treatment
7
Breast cancer therapy efficiency
Breast cancer therapy safety
8
Cardiac toxicity assessment
Drug development
9
Angina relief
11
Chronic angina treatment
Ranolazine efficacy
12
Ventricular arrhythmia suppression
13
Improved angina class
Reduced hospitalizations
14
Proarrhythmia assessment
15
VT treatment
16
Chronic angina relief
Diastolic heart failure treatment
Symptomatic relief
17
Angina relief
Reduced disease progression
Reduced risk factors
18
Antiarrhythmic effects
Improved tolerance
19
Angina pectoris treatment
20
Drug development
21
Left ventricular function preservation
Myocardial ischemia control
22
Improved exercise capacity
Reduced angina episodes
23
Dichloroacetate ischemic heart disease treatment
L-carnitine ischemic heart disease treatment
Ranolazine ischemic heart disease treatment
Ribose ischemic heart disease treatment
Trimetazidine ischemic heart disease treatment
24
Reduced arrhythmias
Reduced torsades de pointes
26
Improved exercise tolerance
Reduced angina
Reduced heart failure
Reduced myocardial ischaemic injury
27
Risk Keywords
Side effects
1
Side effects
2
Adverse events
5
Cost
Ineffectiveness
Side effects
6
Acute renal injury
Bradycardia
Hyperkalemia
7
Cardiotoxicity
8
Torsades de pointes
9
Prolonged QTc
Torsades de pointes
10
Ineffectiveness
Side effects
11
Ranolazine side effects
12
Side effects
14
TdP arrhythmia
15
Morbidity
Side effects
17
QT(c) interval prolongation
20
TdP risk
21
Side effects
22
Adverse effects
23
Proarrhythmic risk
Torsades de pointes
25
Bradycardia
QT prolongation
26
None mentioned
27
Literature analysis of 27 papers
Positive Content
24
Neutral Content
1
Negative Content
2
Article Type
2
1
0
8
25
1.

Effects of ranolazine on various outcomes in patients with stable angina: an updated meta-analysis.

Author: ManolisAthanasios, KallistratosManolis, PoulimenosLeonidas, ZamfirTatiana, ThomopoulosCostas

Angina treatment
Atrial fibrillation prevention
Side effects

This study determined the effect of ranolazine vs. placebo in angina patients on selective measures of the ischemic burden, cardiovascular outcomes, including atrial fibrillation incidence, in-treatment glycohemoglobin levels, permanent discontinuations because of side effects, and the achieved between-arms blood pressure and heart rate difference.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Safety and efficacy of ranolazine in hypertrophic cardiomyopathy: Real-world experience in a National Referral Center.

Author: ArgiròAlessia, ZampieriMattia, DeiLorenzo-Lupo, FerrantiniCecilia, MarchiAlberto, TomberliAlessia, BaldiniKatia, CappelliFrancesco, FavilliSilvia, PassantinoSilvia, ZocchiChiara, TassettiLuigi, GabrieleMartina, MauriziNiccolò, MarchionniNiccolò, CoppiniRaffaele, OlivottoIacopo

Angina relief
Reduced arrhythmic episodes
Side effects

Ranolazine was safe and well-tolerated in patients with hypertrophic cardiomyopathy (HCM). It was effective in relieving angina symptoms and may be considered for patients with HCM and microvascular angina.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Open-label pilot study of ranolazine for cramps in amyotrophic lateral sclerosis.

Author: ChandrashekharSwathy, HamasakiAnai C, ClayRebecca, McCalleyAyla, HerbelinLaura, PasnoorMamatha, JawdatOmar, DimachkieMazen M, BarohnRichard J, StatlandJeffrey

ALS symptom management

This study aimed to determine the safety and tolerability of ranolazine in patients with ALS and evaluate for preliminary evidence of drug-target engagement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

COVID-19-related arrhythmias and the possible effects of ranolazine.

Author: ChukwunyereUgochukwu, SehirliAhmet Ozer, AbaciogluNurettin

Reduced arrhythmias

Ranolazine is a drug used to treat angina and may have antiarrhythmic effects. This review examines the potential for ranolazine to treat arrhythmias associated with COVID-19.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Ranolazine Improves Right Ventricular Function in Patients With Precapillary Pulmonary Hypertension: Results From a Double-Blind, Randomized, Placebo-Controlled Trial.

Author: HanYuchi, ForfiaPaul, VaidyaAnjali, MazurekJeremy A, ParkMyung H, RamaniGautam, ChanStephen Y, WaxmanAaron B

Improved RV function
Adverse events

This longitudinal, randomized, double-blinded, placebo controlled, multicenter study of ranolazine treatment in patients with precapillary pulmonary hypertension (PH) found that ranolazine may improve right ventricular (RV) function. Larger studies are needed to confirm the beneficial effects of ranolazine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Long-Term (3 Years) Outcomes of Ranolazine Therapy for Refractory Angina Pectoris (from the Ranolazine Refractory Registry).

Author: StoreyKatelyn M, WangJulia, GarberichRoss F, BennettNoel M, TraverseJay H, ArndtTheresa L, SchmidtChristian W, HenryTimothy D

Antianginal therapy
Reduced cardiac readmission
Cost
Ineffectiveness
Side effects

Ranolazine was effective in reducing angina symptoms and cardiac readmission in patients with refractory angina pectoris (RAP) at 3-year follow-up, suggesting potential for expanding treatment options for this challenging patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Ranolazine Induced Bradycardia, Renal Failure, and Hyperkalemia: A BRASH Syndrome Variant.

Author: ZaidiSyed Arsalan Akhter, ShaikhDanial, SaadMuhammad, VittorioTimothy J

Angina treatment
Acute renal injury
Bradycardia
Hyperkalemia

This case report describes a case of bradycardia, hyperkalemia, and acute renal injury in an 88-year-old female patient taking ranolazine, an antianginal drug. The patient's symptoms resolved after ranolazine was discontinued, suggesting a potential association between ranolazine and these adverse events.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

9.

Predicting drug-induced arrhythmias by multiscale modeling.

Author: Sahli CostabalFrancisco, YaoJiang, KuhlEllen

Cardiac toxicity assessment
Drug development
Torsades de pointes

This study developed a computational model to predict the cardiac toxicity of drugs. The model accurately predicted the risk of torsades de pointes, a potentially fatal arrhythmia, for quinidine, a high-risk drug. This model has potential for accelerating safe drug development.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Drug-induced torsades de pointes in an underserved urban population. Methadone: is there therapeutic equipoise?

Author: RomeroJorge, BaldingerSamuel H, Goodman-MezaDavid, EngstromKrysthel, ValenciaCarolina R, GoliveAnjani, MedranoFrancisco, RangasamySabarivinoth, MakkiyaMohammed, FisherJohn D, GrossJay, KrumermanAndrew, KimSoo, GarciaMario J, Di BiaseLuigi, FerrickKevin J

Prolonged QTc
Torsades de pointes

A retrospective review of 2735 patients with prolonged QTc found that methadone was by far the leading medication implicated in the development of torsades de pointes (TdP), even though it was not the most common QT-prolonging medication in the population. Methadone was an independent predictor of TdP in both univariate and multivariate analyses. Other medications associated with TdP included furosemide, SSRIs, amiodarone, and dofetilide.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Ranolazine refractory angina registry: 1-year results.

Author: BennettNoel M, IyerVijay, ArndtTheresa L, GarberichRoss F, TraverseJay H, JohnsonRandall K, PouloseAnil K, LipsAnnie, MorganJill M, HenryTimothy D

Angina relief
Ineffectiveness
Side effects

Ranolazine, an antianginal drug, was found to be effective in treating refractory angina, but only 57% of patients remained on treatment after one year due to side effects, suboptimal effectiveness, or cost.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Ranolazine for the suppression of ventricular arrhythmia: a case series.

Author: YeungEric, KrantzMori J, SchullerJoseph L, DaleRita A, HaigneyMark C

Ventricular arrhythmia suppression

Premature ventricular complexes (PVCs) and ventricular tachycardia (VT) are arrhythmias that can lead to serious health problems. This study examines the potential for ranolazine, a drug that blocks the late sodium current, to suppress ventricular arrhythmias.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

14.

Impact of ranolazine on clinical outcomes and healthcare resource utilization in patients with refractory angina pectoris.

Author: LingHua, PackardKathleen A, BurnsTammy L, HillemanDaniel E

Improved angina class
Reduced hospitalizations
Side effects

Ranolazine improved angina class and reduced hospitalizations in patients with refractory angina pectoris.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Ranolazine reduces ventricular tachycardia burden and ICD shocks in patients with drug-refractory ICD shocks.

Author: BunchT Jared, MahapatraSrijoy, MurdockDavid, MoldenJamie, WeissJ Peter, MayHeidi T, BairTami L, MaderKaty M, CrandallBrian G, DayJohn D, OsbornJeffrey S, MuhlesteinJoseph B, LappeDonald L, AndersonJeffrey L

VT treatment

Ranolazine, a drug typically used for angina and ischemia, might be a treatment option for patients experiencing recurrent ventricular tachycardia (VT) despite standard antiarrhythmic-drug (AAD) therapies, leading to repeated implantable cardioverter defibrillator (ICD) shocks. However, its efficacy, outcomes, and tolerance in this specific context remain unclear and require further investigation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Ranolazine: a new approach to treating an old problem.

Author: ReddyBharath M, WeintraubHoward S, SchwartzbardArthur Z

Chronic angina relief
Diastolic heart failure treatment
Symptomatic relief
Morbidity
Side effects

Ranolazine is a drug that has been shown to provide symptomatic relief for patients with chronic angina. This review discusses the physiology of the sodium channel, the pharmacology of ranolazine, and its clinical use in the treatment of chronic angina.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

The antiarrhythmic effects of ranolazine.

Author: FosterNathan J, HainesDavid E

Antiarrhythmic effects
Improved tolerance

Ranolazine is a drug that is approved for the treatment of angina. It is being investigated as a potential antiarrhythmic drug because it can modify ionic currents in cardiac cells, which are responsible for generating action potentials. Unlike other antiarrhythmic drugs, ranolazine is well tolerated and has few side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Ranolazine for chronic stable angina.

Author: NashDavid T, NashStephen D

Angina pectoris treatment
QT(c) interval prolongation

Ranolazine, a new antianginal drug, has demonstrated efficacy in increasing exercise capacity and reducing anginal episodes. However, potential side effects include dizziness, constipation, nausea, and QT(c) interval prolongation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Safety and efficacy of extended-release ranolazine in patients aged 70 years or older with chronic stable angina pectoris.

Author: RichMichael W, CragerMichael, McKayCharles R

Improved exercise capacity
Reduced angina episodes
Adverse effects

Extended-release ranolazine is effective and safe for patients with angina, regardless of age. However, adverse effects are more common in older patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Antiarrhythmic and proarrhythmic properties of QT-prolonging antianginal drugs.

Author: SinghBramah N, WadhaniNitin

Reduced arrhythmias
Reduced torsades de pointes
Bradycardia
QT prolongation

Amiodarone is a drug that is used to treat irregular heartbeats. Ranolazine is another drug that has similar effects but may be safer than other drugs that are used to treat irregular heartbeats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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