Ranolazine - time to have full effect

[cocobearbhf]

Hi all

After having 3 stents fitted in April and May this year following an NSTEMI event, I am still getting some chest pain. I still have a partially blocked artery that the cardiologist wants to manage with medication.

The cardiologist has put me on Ranolazine (375mg twice a day) to try to combat the pain I am still getting, and there is no doubt that this has helped significantly. And the improvement has continued now for four/five weeks - gradually getting better over time. This was to be expected (apparently).

I wonder - does anyone have a view on how long it will take to have its full effect (when will it stop improving)?

I still have some pain (although reduced) and have a call with my doctor on Thursday. I am considering asking for an uplift to 500mg x2 (which is pre-approved by my cardiologist) but I don't want to do that it it is going to keep getting better for another few weeks yet on the existing dose.

Thoughts welcome.

[Tos92]

Hi cocobearbhf

I was prescribed Ranolazine however, I couldn’t tolerate the side effects and stopped. I’m happy to hear it is working for you.

It is possible to build a tolerance to any medication, but as you’ve only been on it for a month or so on a 375mg dosage twice a day, I personally don’t think it’s possible to develop a tolerance to medication that quickly.

I don’t have anymore experience to offer you on that front I’m afraid, but your cardiologist will definitely be able to tell you whether you should wait longer and continue on your current dosage, or have it increased.

All the best.

Tos

[Milkfairy Heart Star]

Hello,

Ranolazine is anti angina medication that has mixed reviews from patients.

Some research suggests it's only affective in 50% of patients.

The research suggests it's more affective in people with angina due to obstructive coronary artery disease or microvascular angina.

I was prescribed ranolazine many years ago. It gave me arrthymias so I stopped taking it.

A lower dose is usually prescribed at first and increased if necessary under supervision of your Cardiologist.

Below is some information from the National Institute of Clinical Excellence NICE .

"Dose and titration:

The initial dose of ranolazine is 375 mg twice a day.

After 2–4 weeks increase the dose to 500 mg twice a day.

If the person is still experiencing symptoms of angina, and is tolerating ranolazine, increase the dose to a maximum of 750 mg twice a day."

cks.nice.org.uk/topics/angi...

I suggest you keep a log of your symptoms and discuss with your doctor about whether it's appropriate for you to increase your dose of Ranolazine.

It sounds as though your Cardiologist anticipated that your dose of Ranolazine might need increasing as they have already preapproved a higher dose.

I hope you are angina free soon.

[Kristin1812 Heart Star in reply to Milkfairy]

Sorry cocobear….just wanted to support Milkfairys comments. I too got arrthymias with Ranolazine, which went when it was stopped. It was effective with my angina.

[Jako999]

We sound similar, I was still getting chest pains and short of breath and using GTN on a regular basis following my 2 HT and a quadruple CABG. Like you after starting on this new med, I would say it all reduced by around 50%.

I would say it took about a month to all find a level. I’m really pleased, still waiting to see my cardiologist again to what the next steps are.

I’m glad it’s helped you as well, let’s hope it stays that way👍

[Theshed]

Hey, cocobearbhf,

As per Milkfairy’s quoted NICE advice, my cardiologist followed this to the letter and now, on taking 2x 750 Ranolazine per day (along with 4 other tablets), I find my symptoms are brilliantly reduced.

Ranolazine was the real game changer for me and allows me to engage in normal activities most of the time, although, like everyone else on here, I have some pretty bad days as well, usually following a series of stupidly overly active days….maybe I’ll learn to manage these more successfully in the future!!😝

Best wishes for the future.

[Tabac]

Ranolazine initially didn't work for me until I reached the 2 x 750 mg dose. I didn't get any side effects but found that after six months or so it didn't help so eventually stopped taking it. I personally found that Amlodipine helped reduce the angina pain although initally prescribed as a BP drug.