Ranozex 500 - Tablet Ranolazine - 500mg 10 Tablet(s) / Strip Sun Pharmaceutical (Bangladesh) Ltd. Introduction: Ranozex 500 is a medicine used for the management of angina (heart-related chest pain). It helps to prevent new attacks of angina, but it does not stop an acute attack, once it has started. It relieves chest pain by making the heart work more efficiently. Ranozex 500 should be taken in the dose as advised by your doctor, at the same time each day. It should be taken with food to avoid stomach upset. Your doctor will decide how often you should take this medicine. This may change from time to time depending on how well it is working. You... Uses of Ranozex 500: Angina (heart-related chest pain) Side effects of Ranozex 500: NauseaVomitingHeadacheDizzinessConstipationWeakness How to use Ranozex 500: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ranozex 500 is to be taken with food. How Ranozex 500 works: Ranozex 500 is an anti-anginal medication. It works by decreasing the oxygen requirement of the heart by relaxing heart muscle. What if you forget to take Ranozex 500?: If you miss a dose of Ranozex 500, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose. Indication: Chronic angina Administration: May be taken with or without food. Adult Dose: Oral Chronic angina 500 mg PO BID initially; may increase to 1,000 mg PO BID, if needed Hepatic Impairment: Mild: Dose titration needed. Moderate to severe: Contraindicated. Renal Dose: Renal Impairment Mild to moderate (CrCl 30-80 mL/min): Dose titration needed. Severe (CrCl <30 mL/min): Contraindicated. Contraindication: Taking strong inhibitors of CYP3A (e.g., ketoconazole, clarithromycin, nelfinavir) Taking inducers of CYP3A (e.g., phenobarbital, rifampicin)Significant hepatic impairment Mode of Action: Ranolazine exert its antianginal and anti-ischaemic effects through concentration-, voltage-, and frequency-dependent inhibition of the late Na current and other cardiac ion channels and transporters. It may decrease the magnitude of the late Na current resulting in a net reduction in intracellular Na concentrations, reversal of Ca overload, restoration of ventricular pump function, and prevention of ischaemia-induced arrhythmias. Its antianginal effects are not dependent upon reductions in heart rate or BP and QT interval prolongation effect is caused by inhibition of rapid delayed rectifier K current (IKr), which prolongs the ventricular action potential. Precaution: Heart rhythm problems (e.g., bradycardia, QT prolongation, ventricular tachycardia), liver problems, certain uncorrected mineral imbalances (low potassium/magnesium levels), severe kidney problems. Lactation: Unknown if excreted in breast milk; discontinue or do not nurse Side Effect: >10% Dizziness (5-13%) 1-10% Nausea (4-9%),Constipation (5-8%),Headache (3-6%),Syncope (3%) Frequency Not Defined Palpitations,Bradycardia,Peripheral edema,Prolonged QT interval,Abdominal pain,Dry mouth,Dyspepsia,Anorexia,Vomiting,Hematuria,Dyspnea,Tinnitus,Vertigo,Blurred vision,Vasovagal syncope,Confusional state,Hematuria,Hyperhidrosis Interaction: Increased plasma levels w/ moderate CYP3A4 inhibitors (e.g. diltiazem, fluconazole, erythromycin), P-glycoprotein inhibitors (e.g. verapamil, ciclosporin) and CYP2D6 inhibitors (e.g. paroxetine). May increase plasma digoxin concentrations. May increase risk of rhabdomyolysis w/ simvastatin. May increase plasma concentrations of atorvastatin, other statins (e.g. lovastatin) and CYP3A4 substrates w/ narrow therapeutic range (e.g. tacrolimus, sirolimus, everolimus). May increase plasma exposure of metformin. Increased risk of ventricular arrhythmias w/ other drugs that prolong QT interval (e.g. terfenadine, astemizole, mizolastine). Potentially Fatal: Increased plasma concentrations leading to increased adverse effects w/ CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, HIV protease inhibitors, clarithromycin, telithromycin, nefazodone). Decreased plasma...