Drug interactions
Ranolazine + Riociguat
Severity: Moderate
Ranolazine and Riociguat: 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 is a weak CYP3A and P-gp inhibitor and may modestly increase riociguat exposure. The main concern is additive hypotension and dizziness.
What this interaction means in plain words
Ranolazine and Riociguat 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 belongs to Cardiovascular; Riociguat belongs to Cardiovascular.
Why it happens
Weak inhibition of CYP3A4 and P-gp by ranolazine, reducing riociguat clearance.
What to do
Monitor blood pressure and symptoms of hypotension, especially at initiation; reduce riociguat dose if needed.
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 Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide mononitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
Frequently asked questions
Can I take Ranolazine with Riociguat?
MediHelp rates the interaction as moderate. Ranolazine and Riociguat 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 is a weak CYP3A and P-gp inhibitor and may modestly increase riociguat exposure. The main concern is additive hypotension and dizziness.
How serious is the interaction between Ranolazine and Riociguat?
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 blood pressure and symptoms of hypotension, especially at initiation; reduce riociguat dose if needed.
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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