Drug interactions
Perhexiline + Ranolazine
Severity: Moderate
Perhexiline 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
Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index, with toxicity including hepatotoxicity, neuropathy and hypoglycemia. Ranolazine's weak CYP2D6 inhibition could raise perhexiline levels, and both drugs can affect QT.
What this interaction means in plain words
Perhexiline 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
Ranolazine weakly inhibits CYP2D6, reducing perhexiline clearance; additive QT effects are also possible.
What to do
Monitor plasma perhexiline concentrations and liver function when starting ranolazine. Reduce the perhexiline dose if levels rise, and check the ECG for QTc prolongation.
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 Perhexiline with Ranolazine?
MediHelp rates the interaction as moderate. Perhexiline 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. Perhexiline is cleared by CYP2D6 and has a narrow therapeutic index, with toxicity including hepatotoxicity, neuropathy and hypoglycemia. Ranolazine's weak CYP2D6 inhibition could raise perhexiline levels, and both drugs can affect QT.
How serious is the interaction between Perhexiline 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: Monitor plasma perhexiline concentrations and liver function when starting ranolazine. Reduce the perhexiline dose if levels rise, and check the ECG for QTc prolongation.
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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