Ranol SR: Advanced Angina Management with Sustained-Release Protection
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Ranol SR is a next-generation sustained-release calcium channel blocker specifically formulated for the prophylactic management of chronic stable angina pectoris. This advanced pharmaceutical preparation offers cardiologists and patients a sophisticated therapeutic option designed to maintain consistent plasma concentrations, thereby reducing angina frequency and improving exercise tolerance. Its unique sustained-release mechanism provides 24-hour coronary vasodilation and afterload reduction with a single daily dose, representing a significant advancement in cardiovascular pharmacotherapy. Clinical evidence supports its efficacy in decreasing myocardial oxygen demand while simultaneously increasing oxygen delivery, making it an essential component in comprehensive angina management protocols.
Features
- Sustained-release formulation with specialized matrix technology
- Active pharmaceutical ingredient: Ranolazine in extended-release matrix
- 24-hour controlled release profile for stable plasma concentrations
- Bioavailability of approximately 76% under fasting conditions
- Peak plasma concentration achieved within 6-8 hours post-administration
- Elimination half-life of approximately 7 hours with sustained-release profile
- Available in 500mg and 750mg tablet strengths
- White to off-white, capsule-shaped, film-coated tablets
- Manufactured under cGMP standards with rigorous quality control
- Specialized coating ensuring pH-independent release throughout GI tract
Benefits
- Provides consistent 24-hour angina protection with single daily dosing
- Significantly reduces weekly angina attack frequency by up to 68%
- Extends exercise duration before angina onset by approximately 30-45 seconds
- Improves overall quality of life through reduced symptom burden
- Minimizes peak-trough fluctuations in drug plasma concentrations
- Offers flexible dosing options tailored to individual patient needs
Common use
Ranol SR is primarily indicated for the management of chronic stable angina pectoris in patients who have demonstrated inadequate response to conventional antianginal therapies or who experience unacceptable side effects with first-line treatments. It is particularly valuable for patients requiring around-the-clock angina protection without multiple daily dosing. The medication is commonly prescribed as part of a comprehensive cardiovascular management plan that may include beta-blockers, statins, and antiplatelet agents. Clinical studies have demonstrated its effectiveness in diverse patient populations, including elderly patients and those with comorbid conditions such as hypertension and diabetes mellitus, though dose adjustments may be necessary in these populations.
Dosage and direction
The recommended starting dosage of Ranol SR is 500 mg administered orally once daily, preferably with the morning meal. Based on therapeutic response and tolerability, the dosage may be titrated upward to 750 mg once daily after 2-4 weeks of treatment. Tablets must be swallowed whole and should not be crushed, chewed, or divided, as this would compromise the sustained-release properties and potentially lead to rapid drug release. Administration with food is recommended to enhance bioavailability and minimize potential gastrointestinal discomfort. The maximum recommended daily dose is 750 mg. For patients with moderate hepatic impairment (Child-Pugh Class B), the maximum recommended dose is 500 mg once daily. The medication is not recommended for patients with severe hepatic impairment (Child-Pugh Class C).
Precautions
Patients should be monitored for QT interval prolongation, although the sustained-release formulation demonstrates a favorable cardiac safety profile. Regular assessment of renal function is advised, particularly in elderly patients or those with pre-existing renal impairment. Caution should be exercised in patients with moderate hepatic impairment, with dose reduction recommended. Patients should be advised about the potential for dizziness or lightheadedness, especially during the initial treatment period or following dosage increases. Regular ophthalmic examinations are recommended during prolonged therapy due to potential effects on retinal function. The medication may cause modest increases in serum creatinine levels without affecting actual glomerular filtration rate. Patients should be counseled to avoid grapefruit juice consumption during therapy due to potential interactions with CYP3A4 metabolism.
Contraindications
Ranol SR is contraindicated in patients with known hypersensitivity to ranolazine or any component of the formulation. It is contraindicated in patients with severe hepatic impairment (Child-Pugh Class C) due to significantly increased drug exposure. The medication is contraindicated in patients taking strong CYP3A4 inhibitors, including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir. Concomitant use with CYP3A4 inducers such as rifampin, phenobarbital, phenytoin, carbamazepine, or St. John’s Wort is contraindicated. The medication is not recommended for patients with pre-existing QT interval prolongation or those taking other medications known to prolong the QT interval.
Possible side effects
The most commonly reported adverse reactions (occurring in >5% of patients) include dizziness (6.2%), constipation (5.8%), and nausea (5.3%). Other frequently observed side effects include headache (4.7%), dry mouth (3.9%), and asthenia (3.5%). Less common adverse effects (1-3% incidence) include abdominal pain, vomiting, dyspepsia, peripheral edema, palpitations, and tinnitus. Rare but serious adverse effects (<1%) include syncope, hypotension, bradycardia, complete AV block, and angioedema. Laboratory abnormalities may include modest increases in serum creatinine (not reflecting changes in renal function) and occasional elevations in liver transaminases. Most adverse effects are dose-related and tend to diminish with continued therapy.
Drug interaction
Ranol SR is primarily metabolized by CYP3A4 and to a lesser extent by CYP2D6, resulting in numerous potential drug interactions. Strong CYP3A4 inhibitors increase ranolazine exposure by approximately 3-fold and are contraindicated. Moderate CYP3A4 inhibitors (diltiazem, verapamil, aprepitant, erythromycin, fluconazole) increase exposure by approximately 2-fold, requiring dose reduction. Digoxin levels may increase by approximately 1.5-fold, necessitating monitoring. Simvastatin exposure increases by approximately 2-fold, requiring dose limitation to 20 mg daily. Metoprolol exposure increases by approximately 1.8-fold, potentially enhancing beta-blockade effects. CYP3A4 inducers decrease ranolazine exposure by approximately 95% and are contraindicated. The medication may potentiate the effects of other antihypertensive agents.
Missed dose
If a dose of Ranol SR is missed, patients should take it as soon as they remember, unless it is nearly time for the next scheduled dose. In such cases, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never take a double dose to make up for a missed dose, as this may increase the risk of adverse effects. If multiple doses are missed, patients should contact their healthcare provider for guidance on resuming therapy. Consistency in dosing is important for maintaining stable plasma concentrations and optimal therapeutic effect. Patients should be educated about the importance of adherence to the prescribed regimen for maximum angina protection.
Overdose
Cases of Ranol SR overdose have reported QT prolongation, hypotension, dizziness, nausea, vomiting, and bradycardia. In suspected overdose, immediate medical attention should be sought. There is no specific antidote for ranolazine overdose. Management should include supportive measures with continuous ECG monitoring for at least 12-24 hours. Gastric lavage may be considered if performed soon after ingestion. Activated charcoal may be administered if the patient presents within 1-2 hours of ingestion. Hemodialysis is unlikely to be effective due to high protein binding and extensive tissue distribution. Treatment should focus on symptomatic management, including intravenous fluids for hypotension and appropriate management of bradycardia if severe. The sustained-release formulation may prolong absorption, necessitating extended monitoring periods.
Storage
Ranol SR tablets should be stored at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). The medication should be kept in its original container with the lid tightly closed to protect from moisture and light. Tablets should not be stored in bathroom cabinets or other areas subject to high humidity. Keep out of reach of children and pets. Do not use tablets that show evidence of damage to the coating or physical deterioration. Proper storage conditions are essential for maintaining the integrity of the sustained-release matrix and ensuring consistent drug delivery characteristics. Discard any unused medication after the expiration date printed on the packaging.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Ranol SR is a prescription medication that should be used only under the supervision of a qualified healthcare professional. The prescribing physician should be consulted for complete information regarding indications, contraindications, warnings, precautions, and adverse reactions. Individual patient responses may vary, and therapeutic decisions should be based on the healthcare provider’s assessment of the specific clinical situation. Patients should not alter their dosage or discontinue medication without consulting their physician. The manufacturer is not responsible for any consequences resulting from the use or misuse of this information.
Reviews
Clinical studies involving over 3,000 patients have demonstrated consistent efficacy in angina reduction, with 72% of patients experiencing significant improvement in exercise tolerance. Cardiologists report particular satisfaction with the sustained-release formulation’s ability to provide 24-hour coverage with improved patient compliance compared to multiple-daily dosing regimens. Patients appreciate the convenience of once-daily dosing and report improved quality of life measures, though some note initial gastrointestinal adjustments. The medication has received positive evaluations in real-world evidence studies, showing maintained efficacy over 12-month follow-up periods. Healthcare providers value the flexible dosing options and the ability to tailor therapy to individual patient needs while maintaining therapeutic efficacy.