Alternative to Ranolazine in the UK?

[StillHere71]

I have heart disease suffer from occasional angina (whenever I exert myself eg walk up a slope) and my heart consultant has prescribed Ranolazine (alongside my other meds eg Edoxaban , Tildiem and Candesarten). However the side effects of Ranolazine are horrendous, especially the dizziness so frankly the treatment is worse than the condition. Further, clinical reviews of this drug are hardly encouraging. My consultant seems fixated on this particular drug but I hate using it. So, does anyone know of a safer, less intrusive alternative? I have tried beta blockers but I found the side effects even worse, dangerous even as I almost fell down stairs being so dizzy. Any suggestions most welcome, thank you.

[Milkfairy Heart Star]

You can have angina without obstructed coronary arteries, ANOCA, common causes microvascular dysfunction or coronary vasospasms.

The treatment options for these two types of ANOCA microvascular and vasospastic angina are different.

Following the insertion of stents even after coronary bypass surgery the underlying problem of ANOCA can be revealed.

There are several possible medications available however it's helps to know what's causing your symptoms so you can be offered the appropriate treatment.

Perhaps ask your Cardiologist to determine whether microvascular dysfunction is causing your symptoms?

There are further non invasive tests available.

Ranolazine is often prescribed to help treat microvascular dysfunction causing microvascular angina.

It's a bit of a marmite medication either you love it or hate it!

I hated Ranolazine however I live with vasospastic angina.

[StillHere71 in reply to Milkfairy]

Many thanks. Ok I’ll try to talk to my consultant (not easy!) for further clarification. I think that my quality of life will plummet if I keep taking Ranolazine…oh and I hate Marmite too!

[Suzyh in reply to Milkfairy]

I have a stent and also microvascular dysfunction and am on Ranolazine and am fine with it and have been for 3 years.Guess it effects people differently

[Milkfairy Heart Star in reply to Suzyh]

Good to hear Ranolazine is helping you.

[StillHere71 in reply to Suzyh]

Thanks, glad that you are ok on this.

[Nellier]

I have Microvascular angina and take Ranolazine.I experienced severe dizziness and I monitored my blood pressure which had dropped significantly.

I halved my dose and I'm fine with it now and my blood pressure has returned to normal.

[StillHere71 in reply to Nellier]

Thanks for this…I’ll try halving the dose I think. Much obliged.

[Nellier in reply to StillHere71]

Hi I've just checked my box and it's not a halff dose, I was on 500 twice a day, I'm now on 375 twice a day. Check with your GP. X

[StillHere71 in reply to Nellier]

Shall do!

[Wingnutty]

I was put on Ranalozine and it had no primary effects or side effects on me, so they doubled the dose and that was the same. It was about as much use as a chocolate chisel to me. Even if you can overcome your side effects, it doesn't mean it will help. I suppose I was lucky to not have side effects, but I have come off it now simply because it didn't work for me.

[StillHere71 in reply to Wingnutty]

Interesting! Thank you!

[Sleesa]

Ranolazine is considered the gold standard of meds for angina by most UK Consultants. I have a Cardiologist and Specialist Angina Pain Doctor. It's often used when other meds have failed. It will depend on the type of Angina you have as to which is really best. I have Stable Angina, Microvascular and Vasospastic. Great eh? :/

I did not handle Isosorbide well at all. Constant horrific migraine type headaches. I can tolerate the spray if desperately needed but not a constant intake like meds. The other med I'm on is Nicorandil. That is also for angina and used if Isosorbide is not tolerated. Maybe ask about that. But I swear by Ranolazine. The dizziness does ease a lot and you can take an antihistamine/anti nauseant a day to stop the side effects completely.

For me ,it's not a hard decision . Ranolazine ,Cyclizine or Cetirizine OR I'm constantly in pain and blue lighted to A&E.

All the Angina meds can cause dizziness I'm afraid.

What id also add is that if you have CAD you can get dizziness anyway depending on which artery is clogged.

I'd speak to the nurse on the helpline here or talk to your GP and Consultant.

It's your body. As my Angina specialist says ,"It's no point doing all this if you're miserable. The medication has to be tolerable. "

I hope your doc listens. Maybe request an extra med to stop the dizziness or ask about Nicorandil. I'll warn you though, they all come with some side effects I'm afraid.

[StillHere71 in reply to Sleesa]

Many thanks, your reply is very helpful and enlightening.

[MustyK]

I have been on Ranolazine for many years now. Initially, I was on 750mg a day. It gave me horrendous constipation. I dropped it down slowly to 375mg. I am fine with it

Sorry I do not know any alternatives. As some have already said, it tends to be the "standard" for microangina

[StillHere71 in reply to MustyK]

Thanks for the info, I too am leaning towards a lower dose myself to see how I get on.