Drug interactions
Cenobamate + Ranolazine
Severity: Major
Cenobamate 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
Cenobamate induces CYP3A4, and ranolazine is a CYP3A4 substrate, so ranolazine exposure may fall and antianginal benefit may be lost. Ranolazine labeling advises against use with CYP3A inducers.
What this interaction means in plain words
Cenobamate 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.
Cenobamate belongs to Central Nervous System; Ranolazine belongs to Cardiovascular.
Why it happens
Cenobamate induces CYP3A4, increasing the metabolism of ranolazine.
What to do
Avoid the combination where possible and use another antianginal. If it cannot be avoided, monitor closely for loss of angina control.
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
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Ranolazine?
MediHelp rates the interaction as major. Cenobamate 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. Cenobamate induces CYP3A4, and ranolazine is a CYP3A4 substrate, so ranolazine exposure may fall and antianginal benefit may be lost. Ranolazine labeling advises against use with CYP3A inducers.
How serious is the interaction between Cenobamate 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 the combination where possible and use another antianginal. If it cannot be avoided, monitor closely for loss of angina control.
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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