Drug interactions
Butalbital + Ranolazine
Severity: Major
Butalbital and Ranolazine: major interaction.
Last updated
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.
Summary
Butalbital, a barbiturate, induces CYP3A4 and may reduce ranolazine concentrations, leading to reduced antianginal effect. Inducers of CYP3A are contraindicated with ranolazine, although occasional low-dose butalbital induction is weaker.
What this interaction means in plain words
Butalbital and Ranolazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Induction of CYP3A4 increases ranolazine metabolism.
What to do
Avoid regular use; use a non-barbiturate headache therapy where possible. Monitor angina control if the combination continues.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Butalbital with Ranolazine?
MediHelp rates the interaction as major. Butalbital and Ranolazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Butalbital, a barbiturate, induces CYP3A4 and may reduce ranolazine concentrations, leading to reduced antianginal effect. Inducers of CYP3A are contraindicated with ranolazine, although occasional low-dose butalbital induction is weaker.
How serious is the interaction between Butalbital and Ranolazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular use; use a non-barbiturate headache therapy where possible. Monitor angina control if the combination continues.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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