Ranolazine

A new option in the management of chronic stable angina

Paul P Dobesh, Toby C. Trujillo

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Pharmacotherapy for the management of chronic stable angina has not changed much in the past 10-20 years. Although the use of revascularization has increased, β-blockers, calcium channel blockers, and long-acting nitrates are still widely used in the management of patients with chronic stable angina. Despite the demonstrated effectiveness of these agents, a number of patients do not achieve the American College of Cardiology-American Heart Association goal of freedom from exertional angina attacks. For the first time in more than a decade, a new agent, ranolazine, is available to assist in controlling exertional angina. Ranolazine has a novel mechanism of action of inhibiting the late sodium current during ventricular depolarization. This mechanism contributes to a reduction in intracellular sodium and, therefore, a reduction in intracellular calcium, reducing ischemic injury. Unlike currently available pharmacotherapy for chronic stable angina, ranolazine does not produce clinically meaningful changes in heart rate or blood pressure. A number of clinical trials have demonstrated the ability of ranolazine to increase exercise tolerance, decrease weekly anginal episodes, and decrease sublingual nitroglycerin consumption for breakthrough angina. Based on the results of these trials, ranolazine recently was approved by the United States Food and Drug Administration for treatment of patients with chronic stable angina. Because of ranolazine's pharmacokinetic and pharmacodynamic profile, pharmacists will have to play a significant role in patient selection and monitoring.

Original languageEnglish (US)
Pages (from-to)1659-1676
Number of pages18
JournalPharmacotherapy
Volume27
Issue number12 I
DOIs
StatePublished - Dec 1 2007

Fingerprint

Stable Angina
Sodium
Drug Therapy
Exercise Tolerance
Nitroglycerin
Calcium Channel Blockers
Physiologic Monitoring
United States Food and Drug Administration
Pharmacists
Nitrates
Patient Selection
Ranolazine
Pharmacokinetics
Heart Rate
Clinical Trials
Blood Pressure
Calcium
Wounds and Injuries

Keywords

  • Antianginal agent
  • Chronic stable angina
  • Ranolazine

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Ranolazine : A new option in the management of chronic stable angina. / Dobesh, Paul P; Trujillo, Toby C.

In: Pharmacotherapy, Vol. 27, No. 12 I, 01.12.2007, p. 1659-1676.

Research output: Contribution to journalReview article

Dobesh, Paul P ; Trujillo, Toby C. / Ranolazine : A new option in the management of chronic stable angina. In: Pharmacotherapy. 2007 ; Vol. 27, No. 12 I. pp. 1659-1676.
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