Drug interactions
Erythromycin ethylsuccinate + Ranolazine
Severity: Major
Erythromycin ethylsuccinate and Ranolazine: major interaction.
Last updated Sources: US FDA label
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
Erythromycin is a moderate CYP3A4 inhibitor and raises ranolazine concentrations, increasing dose-related adverse effects and QT prolongation. Erythromycin itself also prolongs QT.
What this interaction means in plain words
Erythromycin ethylsuccinate 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
CYP3A4 inhibition reduces ranolazine clearance, plus additive QT effects.
What to do
Limit ranolazine to 500 mg twice daily with moderate CYP3A inhibitors and monitor ECG. Consider azithromycin or another non-inhibiting antibiotic.
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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References
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 Erythromycin ethylsuccinate with Ranolazine?
MediHelp rates the interaction as major. Erythromycin ethylsuccinate 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. Erythromycin is a moderate CYP3A4 inhibitor and raises ranolazine concentrations, increasing dose-related adverse effects and QT prolongation. Erythromycin itself also prolongs QT.
How serious is the interaction between Erythromycin ethylsuccinate 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: Limit ranolazine to 500 mg twice daily with moderate CYP3A inhibitors and monitor ECG. Consider azithromycin or another non-inhibiting antibiotic.
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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