Ranexa causes minimal changes in heart rate and blood pressure in patients with chronic angina
- The anti-ischemic and antianginal effects of Ranexa do not depend upon reductions in heart rate or blood pressure. In controlled clinical studies, patients treated with Ranexa had minimal changes in mean heart rate (< 2 bpm) and systolic blood pressure (< 3 mm HG).1
- Ranexa does not affect the rate-pressure product, a measure of myocardial work, at maximal exercise.1
- The mechanism of action of ranolazine’s antianginal effects has not been determined.1
- Ranexa at therapeutic levels can inhibit the cardiac late sodium current.1
- The relationship of this inhibition to angina symptoms is uncertain.1
CARISA: In addition to Ranexa, patients were on either atenolol 50 mg, amlodipine 5 mg or diltiazem* CD 180 mg as standard treatment per protocol; sublingual nitrates were used as needed.2
Ranexa may be used with the most common cardiovascular agents
TRIAL DESCRIPTION
CARISA (Combination Assessment of Ranolazine In Stable Angina) was a double-blind, randomized, placebo-controlled clinical trial of 823 patients with chronic angina who received Ranexa 750 mg twice daily, Ranexa 1000 mg twice daily, or placebo for 12 weeks. Patients also received daily doses of atenolol 50 mg, amlodipine 5 mg, or diltiazem CD 180 mg as standard treatment. The primary endpoint was exercise duration on the modified Bruce treadmill test at trough drug levels. Secondary endpoints included exercise duration at peak drug levels, time to angina, time to 1-mm ST-segment depression, angina frequency, and weekly nitroglycerin use.2
*Limit dose of Ranexa to 500 mg twice daily in patients on moderate CYP3A inhibitors (eg, diltiazem, verapamil, aprepitant, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products).1 Read more on Simple Dosing and Usage.
