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Ranolazine extended-release for chronic angina

Laura M Gruen and Carl J Pepine

Chronic angina continues to plague many of our patients, despite revascularization attempts and/or evidence-based medical therapy. Approved in the USA for patients with ischemic heart disease and chronic angina in January 2006, ranolazine extended-release is the latest addition to the armamentarium of antianginal medications. Although the exact mechanism of action to reduce angina and ischemia remains unclear, ranolazine appears to infl uence sodium–calcium homeostasis, and has proven effective in delaying and/or reducing ischemia in patients with angina. This unique medication has a favorable side-effect profi le, with negligible impact on heart rate and blood pressure, in addition to potential antiarrhythmic and antidiabetic actions. This article will review the indications, contraindications and data supporting use of ranolazine in patients with chronic angina.