Razine

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Razine

Method of action: Antianginal, Cardiac Therapy

Treatment option: Angina Pectoris

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Razine

Quick Facts

Property Description
Active ingredient Ranolazine
Form Extended-release tablet
Pharmacological class Antianginal Agent / Late Sodium Current Inhibitor
Common purpose Management of chronic angina
Origin Synthetic organic (Piperazine derivative)

Defining the Antianginal Agent and its Distinction

Razine is a prescription-only medication defined by its active component, Ranolazine, and is formally classified as an Antianginal Agent. This drug belongs to a new class of antianginal drugs and functions specifically as a late sodium current inhibitor. Ranolazine is a synthetic organic compound, specifically a piperazine derivative, that is clinically recognized for its role in stabilizing cardiac tissue.

Ranolazine is an agent used to manage chronic chest pain, or angina, in adults. It is used to help people with persistent chest discomfort related to their heart condition. Its distinction lies in its mechanism as a late sodium current inhibitor, which separates it from traditional agents, such as many beta-blockers, that typically operate by reducing heart rate or blood pressure to achieve their effect. This unique profile is a key differentiating factor in the management of complex cardiac conditions.


Composition and General Therapeutic Purpose

Razine is a single active ingredient product presented as an extended-release tablet and is designed for the oral route of administration. The tablet contains Ranolazine (as the dihydrochloride salt) alongside necessary excipients that ensure the medicine is released slowly into the bloodstream over several hours.

The general therapeutic purpose of Razine is to manage the symptoms of chronic angina and associated chest pressure. It achieves this by working within the heart muscle cells to prevent cellular overload, stabilizing the tissue and allowing the heart to function more efficiently during periods of stress. This sustained-release formulation helps provide continuous protection throughout the day. The extended-release feature is key to maintaining stable levels of the active drug in the body over time, providing a consistent effect for adults managing their condition.

Regulatory References

  1. Ranolazine: MedlinePlus Drug Information

What side effects are possible with Razine?

Official Safety Profile and Adverse Reactions

Regulatory documentation for Razine (Ranolazine) categorizes possible adverse reactions by frequency and the body system affected, providing a structured understanding of its safety characteristics. All information presented is based on official government regulatory sources.

Frequency-Classified Adverse Reactions

Adverse reactions that are officially classified as Common (may affect up to 1 in 10 people) typically involve the Nervous and Gastrointestinal systems. These frequently reported effects include dizziness, headache, constipation, nausea, vomiting, and weakness (asthenia). Less frequently reported, or Uncommon, reactions include bradycardia, palpitations, abdominal pain, and dry mouth.

System-Organ Class Common Documented Effects
Nervous System Dizziness, headache
Gastrointestinal Constipation, nausea, vomiting
Cardiac Bradycardia, palpitations

Serious Safety Constraints

The most significant safety element documented in regulatory labeling is a dose-related prolongation of the QTc interval, which reflects an effect on the heart’s electrical conduction. The official labeling also highlights the potential for Acute Renal Failure in specific patient groups.

Population and Interaction Restrictions

Safety restrictions are explicitly stated for certain patient populations and concurrent medications. Razine is formally contraindicated (should not be used) in individuals with pre-existing severe hepatic impairment or severe renal impairment (creatinine clearance < 30 mL/min). It is also contraindicated for use with both strong CYP3 A inhibitors (e.g., clarithromycin) and strong CYP3 A inducers (e.g., rifampin). Furthermore, a higher incidence of adverse events has been officially reported in elderly patients and those with a low body weight (leq 60 kg).

Overdose and Emergency Response

Overdose and When to Seek Help

If you suspect an overdose of Razine, immediately call emergency medical services or contact a Poison Control Center. Overdose is a medical emergency that requires immediate professional attention for monitoring and supportive care. Early intervention is critical to manage severe symptoms and complications.

Documented Overdose Symptoms

While specific human data for Razine overdose is limited, official regulatory information for drugs with a similar profile outlines a set of anticipated signs and symptoms. A drug overdose may be associated with profound central nervous system depression, leading to states of heavy sedation or unresponsiveness. The major physiological systems affected may include the cardiovascular and respiratory systems, which could manifest as slowed breathing, significantly decreased heart rate (bradycardia), and dangerously low blood pressure (hypotension).

In cases of acute toxicity, symptoms can also include disorientation, confusion, and other complications such as metabolic acidosis. Accidental exposure or high-dose ingestion may require supportive care to maintain vital functions, especially airway, breathing, and circulation.

Emergency Response

Since Razine is not an opioid, the standard overdose reversal medication for opioids (naloxone) is not known to reverse its effects. However, if Razine is suspected to have been taken with other substances, naloxone may still be administered by first responders. The required emergency action involves immediate stabilization, careful monitoring of vital signs, and appropriate management of symptoms by medical professionals. Supportive treatment, including assisted ventilation or specific therapies to manage low blood pressure, is the established course of action in an overdose scenario.

Immediate medical help is required for any known or suspected overdose to ensure the patient receives the necessary intervention to manage potentially life-threatening effects.

Therapeutic Uses of Razine

What Razine Treats: Main Uses and Benefits

Razine (Ranolazine) is used to treat chronic angina—the ongoing chest pain or pressure linked to cardiac functional stress. The medication is used for managing symptomatic areas including persistent chest discomfort, the frequency of recurrent anginal attacks, and symptoms that interfere with physical activity.

Managing Symptoms and Supporting Functional Stability

Razine is utilized in the long-term daily management of chronic stable angina pectoris, applied where additional symptomatic support is needed for recurring chest pain, pressure, and tightness. The medication is used in conditions characterized by periods of heightened symptoms where assistance in stabilizing discomfort is required.

“Razine is used to help with managing the frequency of recurrent anginal attacks and supporting functional stability in routine activities.”

The therapeutic benefit may assist with easing the overall burden of persistent anginal discomfort, helping to stabilize symptoms and may assist with managing disruptive episodes, particularly those triggered by physical exertion or stress. This offers supportive relief and may help patients cope more steadily with symptom fluctuations.


Quick Fact: Relief for Chronic Angina

Category Description
Primary Indication Chronic Stable Angina Pectoris
Symptom Target Recurring Chest Pain and Pressure
Core Benefit Supportive management of symptoms related to physical activity
Context of Use Long-term, Daily Management

Regulatory References

  1. NIH MedlinePlus overview

Eligibility and Restrictions for Use

Who Can and Cannot Use Razine?

Eligibility for Razine (Ranolazine) is strictly defined by regulatory guidelines based on age, physiological status, and concurrent conditions. Razine is approved only for use in adults (individuals 18 years of age and older). Safety and efficacy are not established in the pediatric population, and use is not recommended in individuals under 18.


Absolute Contraindications

Use is contraindicated (must not be used) in patients with severe hepatic impairment (severe liver disease). It is also contraindicated for patients concurrently taking strong inhibitors of the CYP3A enzyme (e.g., ketoconazole) or strong inducers of the CYP3A enzyme (e.g., rifampicin, St. John’s Wort). Use is also contraindicated in mothers who are breastfeeding.

Use Restrictions and Limitations

Use is not recommended in patients with severe renal impairment (creatinine clearance less than 30 mL/min) or moderate hepatic impairment. Caution is advised for older adults and those with a history of QTc prolongation. Razine is not recommended during pregnancy.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Razine (Ranolazine) interacts with other substances due to its role as a substrate for and inhibitor of the enzyme CYP3A4 and the transporter P-glycoprotein (P-gp). It also inhibits CYP2D6 and the renal transporter OCT2.

Formal Contraindicated Combinations

Co-administration is officially contraindicated with several types of medicines and substances:

  • Strong CYP3A Inhibitors (e.g., ketoconazole, clarithromycin) due to a significant pharmacokinetic increase in Ranolazine exposure.
  • CYP3A Inducers (e.g., rifampin, St. John's Wort) due to a substantial decrease in Ranolazine exposure and loss of effect.
  • Class Ia and Class III Antiarrhythmics (e.g., quinidine, dofetilide) due to a pharmacodynamic interaction that increases the risk of cardiac effects.

Exposure-Modifying Interactions

Interactions with moderate CYP3A inhibitors (e.g., diltiazem, verapamil) result in increased Ranolazine concentrations, necessitating a dose restriction for Razine. Conversely, Razine increases the plasma exposure of several co-administered drugs, including sensitive CYP3A substrates (e.g., simvastatin) and OCT2 substrates (e.g., metformin), requiring dose limitations for these co-administered medicines.

Food and Population Cautions

Consumption of grapefruit juice is restricted as it may increase Ranolazine concentrations. Furthermore, Razine is contraindicated in patients with moderate or severe hepatic impairment and those with severe renal impairment (creatinine clearance < 30 mL/min) due to amplified interaction risks in these populations.

Mechanism of Action

Inhibition of the Late Sodium Current ( I Na,Late)

Razine primarily acts through the selective inhibition of the late inward sodium current ( I Na,Late), a persistent electrical flow through the cardiac sodium channel. This molecular action limits the accumulation of intracellular sodium ions ( Na^+) and initiates a critical molecular cascade.

Downstream Intracellular Cascades

The reduction of intracellular Na^+ concentration consequently modulates the sodium-calcium exchanger (NCX). This leads to a decrease in the influx of calcium ions ( Ca^2+), thereby preventing excessive intracellular Ca^2+ concentration.

Physiological and Metabolic Modulation

This control over ion balance contributes to enhanced myocardial diastolic relaxation (the heart's ability to fill with blood). Additionally, Razine exerts a modulatory effect by mildly inhibiting enzymes in the fatty acid oxidation pathway, shifting the heart muscle's primary energy substrate preference toward glucose utilization. This metabolic adjustment results in a more oxygen-efficient process for generating cellular energy.

Dosage and Administration Information

How to Use Razine — Administration Guidelines

The administration of Razine, whose active ingredient is ranolazine, follows established protocols for its oral, extended-release formulation for long-term daily management. The medication is taken twice daily (BID).

Administration Scope

Feature Instruction
Route of administration Oral (by mouth).
Dosing schedule Initial Dose: Typically 500 mg BID or 375 mg BID. Maximum Dose: 1000 mg BID or 750 mg BID. Titration is based on clinical response, typically after 2–4 weeks.
Timing in relation to meals (if applicable) May be taken with or without food.
Age-group administration rules Older Adults: Careful dose titration is recommended.
Missed-dose rules Skip the missed dose and take the next dose at the regularly scheduled time; the dose should not be doubled.
Special procedural conditions Renal/Hepatic Impairment: Careful dose titration in mild-to-moderate impairment; use is contraindicated in severe hepatic or renal impairment.

Instruction Classifications (High-level)

Classification Description
Administration method type Oral.
Frequency pattern Twice daily (BID), intended for long-term daily management.
Use-context constraints Must be swallowed whole; must not be crushed, broken, or chewed.

Resulting procedural structure

Step sequence:

  • Initiate treatment at the starting dose (e.g., 500 mg or 375 mg), taken twice daily.
  • Swallow the extended-release tablet whole, without breaking or crushing it.
  • If a dose is missed, skip that specific dose and continue with the next scheduled dose.
  • Dose may be adjusted (titrated) to the next level after 2–4 weeks based on clinical assessment.

Connection to the overall use protocol

The instructions define Razine as a twice-daily oral regimen that requires the tablet to be swallowed whole to preserve the drug's intended extended-release pharmacokinetics. The protocol outlines the starting and maximum dose ranges and the specific titration processes for general use and for populations with impaired organ function, standardizing its administrative application.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Razine

Evidence for Use in Chronic Stable Angina

The research exploring Razine’s evaluation in chronic stable angina is based on findings from several randomized controlled trials (RCTs). These short-term studies were often double-blind and placebo-controlled. Razine was studied for use in patients who were already receiving other standard medications for their condition, such as beta-blockers or calcium channel blockers.

Researchers examined how the addition of Razine was studied for outcomes related to angina symptom frequency and intensity in the observed populations. Studies explored whether using Razine as an add-on therapy was associated with changes in symptoms and daily functioning over defined time intervals. Studies reported measurements where the observed populations, when receiving Razine plus standard therapy, patterns related to weekly counts of angina episodes and consumption of nitroglycerin tablets were monitored and described compared to the placebo group.


Studies on Functional Capacity and Symptom Frequency

The trials monitored outcomes reflecting daily functioning or activity level. A key area of research involved controlled exercise tolerance testing on a treadmill. Data showed patterns related to total exercise duration and time until symptoms began were monitored and described during testing in the populations observed while taking Razine. Furthermore, studies explored patient-reported outcomes describing perceived discomfort and overall health status using specialized questionnaires.

Long-Term Evidence, Uncertainty, and Gaps

The primary evidence, which covers symptom and exercise capacity measurement, is based on studies with limited follow-up durations, meaning the durability of the observed patterns over many years is not fully established. While the research examined patient safety and monitored major events, the core studies were not powered to provide definitive information on Razine’s impact on cardiovascular death or myocardial infarction. The primary findings describe group patterns, not personal outcomes, and comparative evidence is lacking for Razine as a standalone treatment versus placebo without any other heart medication.

Key Studies & References

  1. Efficacy of ranolazine in chronic stable angina: a meta-analysis of randomized controlled trials

Frequently Asked Questions (FAQ)

Common questions about Razine (FAQ)

Q: How quickly do people typically start to feel effects from Razine?

A: Razine is an extended-release medicine designed for consistent, long-term daily management. According to official product information, after taking a single dose, the drug reaches its highest concentration in the blood within 2 to 5 hours. To maintain a steady drug level over time, the maximum concentration in the blood is generally achieved after about 3 days of twice-daily administration.

Q: Is Razine considered a long-term treatment?

A: Official product information describes Razine as indicated for the symptomatic treatment of chronic stable angina as an add-on therapy, suggesting it is intended for long-term daily management. Evidence for the drug's use is based on studies with limited follow-up durations, meaning data on the durability of effects spanning many years is not fully established.

Q: Are there any common over-the-counter medicines that interact with Razine?

A: Regulatory documents state that Razine is processed in the body by certain liver enzymes (CYP3A4). Many medicines, including some over-the-counter products, can affect these same enzymes. Any medicine that impacts these processing pathways could potentially change how much Razine stays in your body, or Razine could affect the levels of the other medicine. Therefore, it is generally recommended to verify all co-administered products with a healthcare provider.

Q: Will Razine interfere with my birth control pills?

A: Razine is known to increase the concentration of other medications that are metabolized by the CYP3A4 enzyme. Since some oral contraceptive (birth control) pills are broken down by this same enzyme, there is a potential for interaction. Given this potential, regulatory documents suggest discussing the use of oral contraceptives with a healthcare provider.

Q: Does Razine cause weight changes in most people?

A: Weight changes, including both weight decrease and unusual weight gain or loss, have been reported in official adverse reaction documents. These effects are categorized as uncommon, meaning they may affect up to 1 in 100 people. They are not among the most commonly reported side effects, which include dizziness and headache.

Q: What research is currently being done on Razine?

A: The drug is currently approved for chronic stable angina. While regulatory documents detail the past clinical trials that led to its approval, information about ongoing research themes can be found in official government registries. Previous studies have explored the drug's profile beyond its approved use, though the current regulatory indication remains chronic stable angina.

Q: What if I'm taking herbal supplements—do they interact with Razine?

A: Official labeling specifically states that the herbal supplement St. John’s Wort is contraindicated. This is because it strongly reduces the amount of Razine in the body, leading to a loss of the drug's intended effect. Other herbal products that influence the same liver enzymes (CYP3A4) may also have the potential to interact with Razine.

Q: Will taking Razine make me feel dizzy or tired?

A: Dizziness is officially documented as a common adverse reaction, affecting up to 1 in 10 people. The symptom of feeling weak (asthenia) is also commonly reported. The term 'tiredness' or 'fatigue' is reported less often, in the uncommon category, affecting up to 1 in 100 people.

Q: Is Razine the same kind of medication as [similar drug name]?

A: Razine is classified as a Late Sodium Current Inhibitor, which places it in a newer category of antianginal agents. This unique mechanism of action distinguishes it from traditional heart medications, such as many beta-blockers and calcium channel blockers, which often work primarily by changing heart rate or blood pressure.

Q: Can Razine affect my sleep schedule?

A: Official adverse reaction reports indicate that Razine may affect sleep for some people. Difficulty sleeping (insomnia) and sleepiness or drowsiness (somnolence) have both been reported as uncommon side effects. These effects may affect up to 1 in 100 people.

Q: Do I need any special lab tests while taking Razine?

A: Monitoring of the heart’s electrical activity (QTc interval) is required for some patients according to official product information. Additionally, for individuals with pre-existing kidney issues or low body weight, kidney function (creatinine) should be checked regularly. If Razine is taken with certain other medicines, such as metformin, blood glucose monitoring may be considered based on clinical guidance.

Q: Can Razine affect my ability to drive or operate machinery?

A: Official product information suggests that due to the risk of side effects like dizziness or blurred vision, caution is advised when performing tasks that require concentration, such as driving or operating machinery.

Q: Are there different strengths of Razine available?

A: Razine is manufactured as extended-release tablets in multiple strengths. The available strengths are manufactured to support the dosage ranges outlined in official product information.

Q: How long after stopping Razine does it stay in your system?

A: Regulatory documents list the drug’s apparent terminal half-life as approximately 7 hours. The half-life is the time it takes for the drug level in the blood to decrease by half. Based on this characteristic, the drug is largely eliminated from the body within a few days after the last dose.

Q: Is Razine an addictive medication?

A: Razine is classified as an antianginal agent and is not designated as a controlled substance by regulatory bodies in the United States or other major jurisdictions. This indicates that it has not been determined to have a high potential for abuse or dependence.

Q: How does Razine affect the liver?

A: Razine is metabolized, or processed, extensively by the liver. Due to this, the medicine is formally contraindicated in patients who have pre-existing moderate or severe hepatic (liver) impairment. Rare adverse reactions that have been reported include elevated hepatic enzymes, which suggests a possible effect on the liver that is monitored by lab tests.

Q: What kind of studies support the use of Razine?

A: The drug’s use is supported by randomized, double-blind, placebo-controlled clinical trials, commonly referred to as RCTs. These studies are the standard for testing medications and were primarily designed to assess Razine’s effects as an add-on therapy on measures like exercise duration and the frequency of angina symptoms.

How should Razine be stored and disposed of?

How to Store and Dispose of Razine (Ranolazine)

Official regulatory guidelines for Razine (Ranolazine) specify mandatory storage and disposal procedures to ensure product stability and safety.

Storage Conditions

Razine must be stored at room temperature, specifically between 20 C and 25 C (68 F and 77 F), protected from excess heat and moisture. The medication must be kept in the container it came in and the cap must remain tightly closed. Store the product out of the sight and reach of children at all times.

Disposal Instructions

Unused or expired Razine should not be discarded in household trash or poured down a drain. Dispose of the medicine and its container in accordance with local regulations or via a pharmaceutical take-back program.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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