Cardiology

Ranexa^® (ranolazine)

Ranexa^® (containing the active ingredient ranolazine) is an anti-ischemic and antianginal preparation for the treatment of stable angina pectoris.¹ 

Ranexa^® is indicated as an adjunctive therapy in angina pectoris patients who suffer from recurrent angina pectoris symptoms despite taking conventional antianginosa or who cannot tolerate taking, for example, beta-blockers or calcium antagonists due to contraindications or side effects. The substance is offered as a sustained-release tablet in three different dosages.²

References: 1 Chaitman BR et al.; J Am Coll Cardiol 2004; 43:1375-1382, 2 Drug information Ranexa®, 3 Spinka F. et al.; BMJ Open 2019;9(9)

Deep relaxation for the heart

Despite PCI (percutaneous coronary intervention) and first-line therapy (beta-blockers and/or calcium antagonists), a large proportion of Austrian patients with stable angina pectoris (AP) continue to suffer from regular AP attacks.^3,4

Ranolazine inhibits late sodium influx and prevents sodium-induced calcium overload in ischemic myocardium. As a result, administration of Ranexa^® causes a reduction in diastolic wall stress, and microcirculation and oxygen delivery in the myocardium are improved. This leads to better symptom control in AP patients.⁵ Both the number of weekly AP attacks and the frequency of use of short-acting nitrates are significantly reduced, as has also been shown in Austrian patients. The associated improvement in quality of life after only 12 weeks of treatment is also significant.⁴ Ranexa^® is hemodynamically neutral.^2,6,^* (Both blood pressure and heart rate are minimally affected by Ranexa^®). Concomitant diseases such as diabetes mellitus or COPD also do not limit the use of Ranexa^®.^2,7 The antianginal efficacy of Ranexa^® has been demonstrated even in patients with stable AP and concomitant diabetes mellitus.^6,8 In these patients, Ranexa^® additionally demonstrated a significant reduction in HbA1c6 without increasing the risk of hypoglycemia.⁸,^**.

DOSAGE:

Ranexa^® should be dosed up: It is recommended to increase the starting dose of 375mg 2x tgl. to 500mg 2x tgl. after 2-4 weeks and finally to 750mg 2x tgl. if tolerated and the patient is not yet symptom-free.²

Rule text:⁹ As adjunctive therapy for symptomatic treatment of chronic stable angina pectoris in patients with coronary artery disease in whom

• Beta-blockers (preparations with appropriate indication from the group with ATC code C07) are not sufficiently effective (as add-on therapy), contraindicated, or intolerable and in whom 

• Calcium channel blockers (ATC code C08) from the green range are not sufficiently effective (as add-on therapy), contraindicated, or intolerable.

References: 4 Zweiker R et al., Wien Klin Wochenschr 2019;131:165-173, 5 Jacobshagen C et al., Dtsch Med Wochenschr 2013;138;842-7, 6 Timmis et al., Eur Heart J 2006; 27: 42 – 48, 7 Lopez-Sendon J et al., British Journal of Cardiology 2012; Volume 19 Supplement 2, 8 Kosiborod M. et al.,J Am Coll Cardiol 2013;61(29):2038-2045, 9 Erstattungskodex, *Acc Drug information Ranexa®: Minimal reduction in mean heart rate (< 2 beats per minute) and mean systolic blood pressure (< 3 mmHG), ** Ranexa® is not indicated for the treatment of diabetes mellitus.

AT-WEB-10-10-2021