Drug interactions
Paliperidone + Ranolazine
Severity: Moderate
Paliperidone 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
Ranolazine may raise paliperidone exposure by inhibiting intestinal and renal P-glycoprotein efflux. Both drugs can also prolong the QTc interval, so the combination may raise the risk of ventricular arrhythmia including torsades de pointes.
What this interaction means in plain words
Paliperidone 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.
Paliperidone belongs to Central Nervous System; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation plus P-glycoprotein inhibition by ranolazine increasing paliperidone absorption and reducing its clearance.
What to do
Obtain a baseline ECG and monitor QTc and electrolytes (potassium, magnesium) when combining them. Reduce the paliperidone dose if adverse effects emerge or QTc lengthens, and avoid the combination in patients with other QT risk factors.
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
Other interactions of Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Paliperidone with Ranolazine?
MediHelp rates the interaction as moderate. Paliperidone 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. Ranolazine may raise paliperidone exposure by inhibiting intestinal and renal P-glycoprotein efflux. Both drugs can also prolong the QTc interval, so the combination may raise the risk of ventricular arrhythmia including torsades de pointes.
How serious is the interaction between Paliperidone 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: Obtain a baseline ECG and monitor QTc and electrolytes (potassium, magnesium) when combining them. Reduce the paliperidone dose if adverse effects emerge or QTc lengthens, and avoid the combination in patients with other QT risk factors.
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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