Drug interactions
Ranolazine + Tolvaptan
Severity: Moderate
Ranolazine and Tolvaptan: 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 increase tolvaptan exposure by inhibiting P-glycoprotein. Greater exposure could intensify aquaresis and cause excessive water loss or too-rapid sodium correction.
What this interaction means in plain words
Ranolazine and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Ranolazine inhibits P-glycoprotein-mediated efflux of tolvaptan.
What to do
Monitor serum sodium and fluid status closely after starting the combination. Reduce the tolvaptan dose if sodium rises too quickly or dehydration develops.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Ranolazine with Tolvaptan?
MediHelp rates the interaction as moderate. Ranolazine and Tolvaptan 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 increase tolvaptan exposure by inhibiting P-glycoprotein. Greater exposure could intensify aquaresis and cause excessive water loss or too-rapid sodium correction.
How serious is the interaction between Ranolazine and Tolvaptan?
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 serum sodium and fluid status closely after starting the combination. Reduce the tolvaptan dose if sodium rises too quickly or dehydration develops.
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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