Indications & Uses
Ranocor ER 500 is indicated for:
Pharmacology
Ranolazine produces anti-ischemic and antianginal effects that are not dependent on reductions in heart rate or blood pressure. Its exact mechanism of action remains unknown, though at therapeutic levels it is known to inhibit the cardiac late sodium current (INa); how much this inhibition contributes to relief of angina symptoms is not clear. The QT prolongation seen on the surface electrocardiogram with ranolazine results from inhibition of IKr, which prolongs the ventricular action potential.
Absorption: peak plasma concentration (Cmax) is reached in 2 to 5 hours, and the half-life ranges from 6 to 22 hours.
Distribution: across a concentration range of 0.25 to 10 microg/ml, ranolazine is approximately 62% bound to human plasma proteins.
Metabolism and Excretion: ranolazine is metabolized mainly by CYP3A and, to a lesser extent, by CYP2D6. It undergoes rapid and extensive metabolism in the liver and intestine, so less than 5% is excreted unchanged in urine and feces. After a single oral dose of ranolazine solution, about 75% of the dose is excreted in urine and 25% in feces.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Ranolazine is usually started at 500 mg twice daily. Depending on how well symptoms are controlled, the dose may be increased to 1000 mg twice daily, which is also the maximum recommended daily dose. Ranolazine can be taken with or without meals. The tablets should be swallowed whole and should not be crushed, broken or chewed. If a dose is missed, the next dose should be taken at its regular scheduled time; the dose should not be doubled to make up for the one missed. Pediatric use: the safety and effectiveness of Ranolazine in pediatric patients have not been established.
Side Effects
Bradycardia and palpitations (Cardiac Disorders); tinnitus and vertigo (Ear and Labyrinth Disorders); abdominal pain, dry mouth, and vomiting (Gastrointestinal Disorders); peripheral edema (General Disorders and Administrative Site Adverse Events); dyspnea (Respiratory, Thoracic, and Mediastinal Disorders); and hypotension and orthostatic hypotension (Vascular Disorders).
Cautions & Contraindications
Warnings & Precautions
Antogin ER can block QTc and lengthen the QTc interval, and the effect depends on the dose. In clinical experience with patients who had acute coronary syndrome, there was no increase in the risk of proarrhythmia or sudden death. When Antogin ER is taken together with digoxin, the plasma concentration of digoxin rises by about 1.5-fold, so the digoxin dose may need to be lowered accordingly. The dose of other P-gp substrates may also need to be reduced when they are given with Antogin ER. Care is needed when Antogin ER is combined with P-gp inhibitors such as ritonavir or cyclosporine.
Contraindications
Ranolazine should not be used in people who have any of the following. First, those who already have QT prolongation, a change in the heart's electrical rhythm seen on an ECG. Second, those with liver impairment. Third, those taking other medicines that prolong the QT interval. Fourth, those taking strong or moderately strong CYP3A inhibitors. These include ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir and saquinavir, and also diltiazem.
Pregnancy & Breastfeeding
Pregnancy Category C. Well-controlled studies in pregnant women, and studies looking at ranolazine's effects on the developing fetus, are lacking. For this reason, ranolazine should be used during pregnancy only if the potential benefit to the mother is felt to outweigh the potential risk to the fetus.
It is not known whether ranolazine passes into breast milk. Given the possibility of serious adverse effects in a nursing infant, a decision should be made to either stop breastfeeding or stop the medicine, weighing how important it is for the mother's treatment.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Taking high oral doses of Ranolazine causes more dizziness, nausea and vomiting as the dose goes up. High intravenous exposure can also cause diplopia, paresthesia, confusion and syncope. If an overdose happens, general supportive measures are needed, and continuous ECG monitoring may be warranted as well. Ranolazine is about 62% bound to plasma proteins, so hemodialysis is unlikely to be effective in clearing it.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Ranolazine below 30°C, away from light and moisture. Keep it out of the reach of children.
Drug Interactions
Common questions about Ranocor ER 500 500 mg
What is Ranocor ER 500 500 mg Er Tablet?
Ranocor ER 500 500 mg Er Tablet is a medicine that contains Ranolazine. It is made by Popular Pharmaceuticals PLC. It belongs to the Other Anti-anginal & Anti-ischaemic drugs group of medicines.
What is Ranocor ER 500 used for?
Ranocor ER 500 is used for: Angina Pectoris.
What are the side effects of Ranocor ER 500?
Bradycardia and palpitations (Cardiac Disorders); tinnitus and vertigo (Ear and Labyrinth Disorders); abdominal pain, dry mouth, and vomiting (Gastrointestinal Disorders); peripheral edema (General Disorders and Administrative Site Adverse Events); dyspnea (Respiratory, Thoracic, and Mediastinal Disorders); and hypotension and orthostatic hypotension (Vascular Disorders).
Can I take Ranocor ER 500 during pregnancy or while breastfeeding?
Pregnancy Category C. Well-controlled studies in pregnant women, and studies looking at ranolazine's effects on the developing fetus, are lacking. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Ranocor ER 500?
Taking high oral doses of Ranolazine causes more dizziness, nausea and vomiting as the dose goes up. High intravenous exposure can also cause diplopia, paresthesia, confusion and syncope. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Ranocor ER 500?
Store Ranolazine below 30°C, away from light and moisture. Keep it out of the reach of children.
Can I take other medicines with Ranocor ER 500?
Some medicines can interact with Ranolazine, for example: Empagliflozin + Metformin Hydrochloride, Rimegepant, Erythromycin, Digoxin, Cyclosporine, Verapamil Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Ranocor ER 500?
Ranocor ER 500 is a prescription (Rx) medicine. Take it as your doctor advises.