Drug interactions
Grapefruit + Ranolazine
Severity: Moderate
Grapefruit and Ranolazine: moderate 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
Grapefruit juice inhibits intestinal CYP3A4 and can increase ranolazine exposure, raising the risk of dizziness, nausea and QT prolongation. Ranolazine labeling advises limiting the dose with moderate CYP3A inhibitors.
What this interaction means in plain words
Grapefruit and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Intestinal CYP3A4 inhibition increases ranolazine bioavailability.
What to do
Advise patients to avoid large amounts of grapefruit juice or products. If consumption continues, do not exceed 500 mg twice daily.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Grapefruit with Ranolazine?
MediHelp rates the interaction as moderate. Grapefruit and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Grapefruit juice inhibits intestinal CYP3A4 and can increase ranolazine exposure, raising the risk of dizziness, nausea and QT prolongation. Ranolazine labeling advises limiting the dose with moderate CYP3A inhibitors.
How serious is the interaction between Grapefruit and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid large amounts of grapefruit juice or products. If consumption continues, do not exceed 500 mg twice daily.
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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