Drug interactions
Ranolazine + Sirolimus
Severity: Moderate
Ranolazine and Sirolimus: 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 sirolimus concentrations by inhibiting P-glycoprotein and possibly CYP3A4. Higher sirolimus exposure can increase immunosuppression-related toxicity including hyperlipidemia, cytopenias and infection risk.
What this interaction means in plain words
Ranolazine and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Ranolazine inhibits P-glycoprotein and weakly CYP3A4, reducing sirolimus efflux and metabolism.
What to do
Monitor sirolimus trough concentrations when ranolazine is started, adjusted or stopped. Adjust the sirolimus dose according to levels.
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 Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Ranolazine with Sirolimus?
MediHelp rates the interaction as moderate. Ranolazine and Sirolimus 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 sirolimus concentrations by inhibiting P-glycoprotein and possibly CYP3A4. Higher sirolimus exposure can increase immunosuppression-related toxicity including hyperlipidemia, cytopenias and infection risk.
How serious is the interaction between Ranolazine and Sirolimus?
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 sirolimus trough concentrations when ranolazine is started, adjusted or stopped. Adjust the sirolimus dose according to levels.
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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