DAR No 3. Ranolazine (Ranexa®) in stable angina

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A lot of inconveniences for no relevant benefit

Ranolazine is indicated as an adjunct for stable angina in those patients who do not tolerate or are not adequately managed with first line treatments.
It presents modest efficacy in exercise tolerance (24 seconds more) and reduction in the frequency of angina (0.4 episodes less, in 7 weeks). Studies have only compared it to placebo.
No reduction in coronary morbidity or mortality has been shown.
It presents a risk of prolonged QT intervals and a large variety of interactions with other medication employed in cardiovascular disease.
The modest efficacy of ranolazine does not compensate for the risk of severe adverse effects.

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