Drug interactions
amlodipine + ranolazine
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Bidirectional PK interaction: ranolazine (moderate CYP3A inhibitor) may increase amlodipine levels; amlodipine (weak CYP3A inhibitor) may increase ranolazine exposure, potentially causing hypotension/edema or ranolazine adverse effects (including QTc increase).
Mechanism of action
CYP3A4-mediated metabolic inhibition in both directions (ranolazine inhibits CYP3A; amlodipine is a CYP3A substrate and weak inhibitor) leading to increased systemic exposure.
Clinical management
No routine dose change required; start/maintain at lowest effective doses and monitor BP, dizziness/edema, and ranolazine adverse effects. Consider dose reduction of one agent if symptomatic. Check QTc if high ranolazine exposure or risk factors.
Drug reference
References
- Ranexa (ranolazine) Prescribing Information — FDA Label
- Ranolazine: Drug Interactions — Lexicomp
- Amlodipine: Drug Interactions — Lexicomp
Frequently asked questions
Can I take amlodipine with ranolazine?
The interaction is rated: Moderate. Bidirectional PK interaction: ranolazine (moderate CYP3A inhibitor) may increase amlodipine levels; amlodipine (weak CYP3A inhibitor) may increase ranolazine exposure, potentially causing hypotension/edema or ranolazine adverse effects (including QTc increase).
How serious is the interaction between amlodipine and ranolazine?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between amlodipine and ranolazine managed?
No routine dose change required; start/maintain at lowest effective doses and monitor BP, dizziness/edema, and ranolazine adverse effects. Consider dose reduction of one agent if symptomatic. Check QTc if high ranolazine exposure or risk factors.
Why do amlodipine and ranolazine interact?
CYP3A4-mediated metabolic inhibition in both directions (ranolazine inhibits CYP3A; amlodipine is a CYP3A substrate and weak inhibitor) leading to increased systemic exposure.
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