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Ranolazine

Also known as: Ranolazine

Anti-anginalCytochrome P450 3A InhibitorsP-Glycoprotein Inhibitors

Route: Oral

51 interactions on record

Ranolazine has 51 known drug interactions based on U.S. FDA drug labeling data. Of these, 18 are contraindicated combinations that should be avoided entirely. 23 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Carbamazepine, Clarithromycin, Colchicine Tablets 0.5 Mg. Patients taking Ranolazine should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.

Total: 51
Contraindicated: 18
Major: 23
Moderate: 10

Contraindicated (18)

Ranolazine + Carbamazepine— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Clarithromycin— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Colchicine Tablets 0.5 Mg— Strong P-glycoprotein inhibitor causing significant increase in colchicine plasma levels. Contraindicated.
Ranolazine + Indinavir— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Itraconazole— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Ketoconazole— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Levoketoconazole— Concomitant use is contraindicated due to increased risk of QT prolongation and torsades de pointes.
Ranolazine + Nefazodone— Strong CYP3A inhibitor. Do not use with ranolazine extended-release tablets.
Ranolazine + Nelfinavir— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Nirmatrelvir And Ritonavir— Co-administration contraindicated due to potential for serious and/or life-threatening reactions.
Ranolazine + Phenobarbital— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Phenytoin— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Rifabutin— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Rifampin— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Rifapentine— CYP3A inducer. Do not use with ranolazine extended-release tablets.
Ranolazine + Ritonavir— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + Saquinavir— ( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibit…
Ranolazine + St. John'S Wort— CYP3A inducer. Do not use with ranolazine extended-release tablets.

Major (23)

Ranolazine + Alcohol— Alcohol causes rapid release of ranolazine from extended-release formulation, increasing risk of adverse events. Patient…
Ranolazine + Alogliptin And Metformin Hydrochloride— May increase metformin accumulation and risk of lactic acidosis by reducing metformin clearance through OCT2/MATE inhibi…
Ranolazine + Dapagliflozin And Metformin Hydrochloride— OCT2/MATE inhibitor that increases metformin exposure and may increase risk for lactic acidosis.
Ranolazine + Digoxin— Increases digoxin serum concentration by 50%. Requires monitoring and dose reduction of 30-50%.
Ranolazine + Empagliflozin And Metformin Hydrochloride— Ranolazine inhibits metformin clearance via OCT2/MATE, increasing metformin exposure and risk of lactic acidosis.
Ranolazine + Empagliflozin, Linagliptin, Metformin Hydrochloride— OCT2/MATE inhibitor that interferes with renal elimination of metformin, increasing systemic exposure and risk of lactic…
Ranolazine + Empagliflozin, Metformin Hydrochloride— OCT2/MATE inhibitor that may increase systemic metformin exposure and increase risk for lactic acidosis.
Ranolazine + Ertugliflozin And Metformin Hydrochloride— Increases risk of lactic acidosis by reducing metformin clearance through OCT2/MATE inhibition.
Ranolazine + Ezetimibe And Simvastatin— Do not exceed 10 mg/20 mg ezetimibe and simvastatin tablets daily due to increased myopathy risk.
Ranolazine + Glyburide And Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis.
Ranolazine + Linagliptin And Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk of lactic acidosis.
Ranolazine + Lovastatin— Increases risk of myopathy, including rhabdomyolysis, when used with lovastatin.
Ranolazine + Metformin— Reduces metformin clearance by inhibiting renal tubular transport, increasing systemic exposure and lactic acidosis risk…
Ranolazine + Metformin Er 500 Mg— OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk of lactic acidosis.
Ranolazine + Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance and may increase risk of lactic acidosis through increased systemic…
Ranolazine + Metformin Hydrochloride Extended-Release Tablets— OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis.
Ranolazine + Metformin Hydrochloride Tablet— Reduces metformin clearance via OCT2/MATE inhibition, increasing systemic exposure and risk of lactic acidosis.
Ranolazine + Pioglitazole And Metformin Hydrochloride— OCT2/MATE inhibitor reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis. Consider ben…
Ranolazine + Rapamycin— CYP3A substrate with narrow therapeutic range. Dose adjustment may be required as ranolazine increases plasma concentrat…
Ranolazine + Saxagliptin And Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis.
Ranolazine + Simvastatin— Increases risk of myopathy and rhabdomyolysis. Do not exceed simvastatin 20 mg daily.
Ranolazine + Sitagliptin And Metformin Hydrochloride— Inhibits metformin renal clearance via OCT2/MATE transporter interference, increasing systemic metformin exposure and la…
Ranolazine + Tacrolimus— CYP3A substrate with narrow therapeutic range. Dose adjustment may be required as ranolazine increases plasma concentrat…

Moderate (10)

Ranolazine + Canagliflozin And Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis. Consider benefits and ri…
Ranolazine + Cyclosporine— P-gp inhibitor that increases ranolazine exposure. Titrate ranolazine based on clinical response.
Ranolazine + Diltiazem— CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.
Ranolazine + Diltiazem Hydrochloride— Increased exposure of ranolazine due to CYP3A4 inhibition. Limit ranolazine to 500 mg twice daily.
Ranolazine + Erythromycin— 7 DRUG INTERACTIONS Moderate CYP3A inhibitors (e.g., diltiazem, verapamil, erythromycin): Limit ranolazine to 500 mg twi…
Ranolazine + Fluconazole— Moderate CYP3A Inhibitors Limit the dose of ranolazine to 500 mg twice daily in patients on moderate CYP3A inhibitors, i…
Ranolazine + Glyburide-Metformin Hydrochloride— OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis.
Ranolazine + Grapefruit Juice— CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.
Ranolazine + Rimegepant Sulfate— Potent P-gp inhibitor that may increase rimegepant exposure. Avoid another dose within 48 hours when co-administered.
Ranolazine + Verapamil— CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Ranolazine + Carbamazepine⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Clarithromycin⛔Contraindicated

( 7.2 ) 7.1 Effects of Other Drugs on Ranolazine Strong CYP3A Inhibitors Do not use ranolazine with strong CYP3A inhibitors, including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir [see Contraindications (4) , Clinical Pharmacology (12.3) ].

Ranolazine + Colchicine Tablets 0.5 Mg⛔Contraindicated

Strong P-glycoprotein inhibitor causing significant increase in colchicine plasma levels. Contraindicated.

Ranolazine + Indinavir⛔Contraindicated

Ranolazine + Itraconazole⛔Contraindicated

Ranolazine + Ketoconazole⛔Contraindicated

Ranolazine + Levoketoconazole⛔Contraindicated

Concomitant use is contraindicated due to increased risk of QT prolongation and torsades de pointes.

Ranolazine + Nefazodone⛔Contraindicated

Strong CYP3A inhibitor. Do not use with ranolazine extended-release tablets.

Ranolazine + Nelfinavir⛔Contraindicated

Ranolazine + Nirmatrelvir And Ritonavir⛔Contraindicated

Co-administration contraindicated due to potential for serious and/or life-threatening reactions.

Ranolazine + Phenobarbital⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Phenytoin⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Rifabutin⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Rifampin⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Rifapentine⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Ritonavir⛔Contraindicated

Ranolazine + Saquinavir⛔Contraindicated

Ranolazine + St. John'S Wort⛔Contraindicated

CYP3A inducer. Do not use with ranolazine extended-release tablets.

Ranolazine + Alcohol⚠️Major

Alcohol causes rapid release of ranolazine from extended-release formulation, increasing risk of adverse events. Patients should not consume alcohol.

Ranolazine + Alogliptin And Metformin Hydrochloride⚠️Major

May increase metformin accumulation and risk of lactic acidosis by reducing metformin clearance through OCT2/MATE inhibition.

Ranolazine + Dapagliflozin And Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that increases metformin exposure and may increase risk for lactic acidosis.

Ranolazine + Digoxin⚠️Major

Increases digoxin serum concentration by 50%. Requires monitoring and dose reduction of 30-50%.

Ranolazine + Empagliflozin And Metformin Hydrochloride⚠️Major

Ranolazine inhibits metformin clearance via OCT2/MATE, increasing metformin exposure and risk of lactic acidosis.

Ranolazine + Empagliflozin, Linagliptin, Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that interferes with renal elimination of metformin, increasing systemic exposure and risk of lactic acidosis.

Ranolazine + Empagliflozin, Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that may increase systemic metformin exposure and increase risk for lactic acidosis.

Ranolazine + Ertugliflozin And Metformin Hydrochloride⚠️Major

Increases risk of lactic acidosis by reducing metformin clearance through OCT2/MATE inhibition.

Ranolazine + Ezetimibe And Simvastatin⚠️Major

Do not exceed 10 mg/20 mg ezetimibe and simvastatin tablets daily due to increased myopathy risk.

Ranolazine + Glyburide And Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis.

Ranolazine + Linagliptin And Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk of lactic acidosis.

Ranolazine + Lovastatin⚠️Major

Increases risk of myopathy, including rhabdomyolysis, when used with lovastatin.

Ranolazine + Metformin⚠️Major

Reduces metformin clearance by inhibiting renal tubular transport, increasing systemic exposure and lactic acidosis risk.

Ranolazine + Metformin Er 500 Mg⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk of lactic acidosis.

Ranolazine + Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance and may increase risk of lactic acidosis through increased systemic metformin exposure.

Ranolazine + Metformin Hydrochloride Extended-Release Tablets⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis.

Ranolazine + Metformin Hydrochloride Tablet⚠️Major

Reduces metformin clearance via OCT2/MATE inhibition, increasing systemic exposure and risk of lactic acidosis.

Ranolazine + Pioglitazole And Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis. Consider benefits and risks of concomitant use.

Ranolazine + Rapamycin⚠️Major

CYP3A substrate with narrow therapeutic range. Dose adjustment may be required as ranolazine increases plasma concentrations.

Ranolazine + Saxagliptin And Metformin Hydrochloride⚠️Major

OCT2/MATE inhibitor that reduces metformin clearance, increasing systemic exposure and risk for lactic acidosis.

Ranolazine + Simvastatin⚠️Major

Increases risk of myopathy and rhabdomyolysis. Do not exceed simvastatin 20 mg daily.

Ranolazine + Sitagliptin And Metformin Hydrochloride⚠️Major

Inhibits metformin renal clearance via OCT2/MATE transporter interference, increasing systemic metformin exposure and lactic acidosis risk.

Ranolazine + Tacrolimus⚠️Major

CYP3A substrate with narrow therapeutic range. Dose adjustment may be required as ranolazine increases plasma concentrations.

Ranolazine + Canagliflozin And Metformin Hydrochloride🟡Moderate

OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis. Consider benefits and risks of concomitant use.

Ranolazine + Cyclosporine🟡Moderate

P-gp inhibitor that increases ranolazine exposure. Titrate ranolazine based on clinical response.

Ranolazine + Diltiazem🟡Moderate

CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Ranolazine + Diltiazem Hydrochloride🟡Moderate

Increased exposure of ranolazine due to CYP3A4 inhibition. Limit ranolazine to 500 mg twice daily.

Ranolazine + Erythromycin🟡Moderate

7 DRUG INTERACTIONS Moderate CYP3A inhibitors (e.g., diltiazem, verapamil, erythromycin): Limit ranolazine to 500 mg twice daily. Moderate CYP3A Inhibitors Limit the dose of ranolazine to 500 mg twice daily in patients on moderate CYP3A inhibitors, including diltiazem, verapamil, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products [see Dosage and Administration (2.2) , Clinical Pharmacology (12.3) ].

Ranolazine + Fluconazole🟡Moderate

Moderate CYP3A Inhibitors Limit the dose of ranolazine to 500 mg twice daily in patients on moderate CYP3A inhibitors, including diltiazem, verapamil, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products [see Dosage and Administration (2.2) , Clinical Pharmacology (12.3) ].

Ranolazine + Glyburide-Metformin Hydrochloride🟡Moderate

OCT2/MATE inhibitor that reduces metformin clearance and may increase risk for lactic acidosis.

Ranolazine + Grapefruit Juice🟡Moderate

CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Ranolazine + Rimegepant Sulfate🟡Moderate

Potent P-gp inhibitor that may increase rimegepant exposure. Avoid another dose within 48 hours when co-administered.

Ranolazine + Verapamil🟡Moderate

CYP3A inhibitor that increases ranolazine exposure. Limit ranolazine to 500 mg twice daily.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.