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What is ranolazine? Ranolazine is used to treat chronic angina (chest pain). Ranolazine is not for use during an acute (emergency) attack of angina. Ranolazine may also be used for purposes not listed in this medication guide. Warnings You should not take ranolazine if you have cirrhosis of the liver. Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together. Before taking this medicine You should not take ranolazine if you are allergic to it, or if you have: cirrhosis of the liver. Many drugs can interact and cause dangerous effects. Some drugs should not be used together with ranolazine. Your doctor may change your treatment plan if you also use: clarithromycin; nefazodone; St. John's wort; antifungal medicine--itraconazole, ketoconazole; HIV or AIDS medicine--indinavir, lopinavir/ritonavir, nelfinavir, ritonavir, saquinavir; seizure medicine--carbamazepine, phenobarbital, phenytoin; or tuberculosis medicine--rifabutin, rifampin, rifapentine. Tell your doctor if you have ever had: long QT syndrome (in you or a family member); liver disease; or kidney disease. Tell your doctor if you are pregnant or breastfeeding. How should I take ranolazine? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. You may take ranolazine with or without food. Swallow the tablet whole and do not crush, chew, or break it. Chronic angina is often treated with a combination of drugs. Use all medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice. Call your doctor if your symptoms do not improve, or if they get worse. You will need frequent medical tests to check your heart and kidney function. Store at room temperature away from moisture and heat. What happens if I miss a dose? Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause nausea, vomiting, numbness or tingling, dizziness, double vision, confusion, or fainting. What should I avoid while taking ranolazine? Avoid driving or hazardous activity until you know how ranolazine will affect you. Your reactions could be impaired. Grapefruit may interact with ranolazine and lead to unwanted side effects. Avoid the use of grapefruit products. Ranolazine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: a light-headed feeling, like you might pass out; fast or pounding heartbeats, fluttering in your chest; or kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath. Common side effects may include: nausea, constipation; headache; or dizziness. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Ranolazine dosing information Usual Adult Dose for Angina Pectoris: 500 mg orally twice a day; increase to 1000 mg orally twice a day as needed Maximum dose: 1000 mg orally twice a day Use: Treatment of chronic angina What other drugs will affect ranolazine? Tell your doctor about all your current medicines. Many drugs can affect ranolazine, especially: any other medicine to treat heart disease; an antibiotic or antifungal medicine; cholesterol-lowering medicine; oral diabetes medicine; medicine to prevent organ transplant rejection; medicine to treat a mental illness; or medicine to treat or prevent nausea and vomiting caused by chemotherapy or radiation. This list is not complete and many other drugs may affect ranolazine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.