Ranol SR: Advanced Angina Management with Sustained-Release Protection
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Ranol SR is a next-generation antianginal medication engineered for superior cardiovascular protection. Utilizing a sophisticated sustained-release formulation, it ensures consistent therapeutic plasma levels, reducing angina frequency and improving exercise tolerance in patients with chronic stable angina pectoris. Its targeted mechanism offers hemodynamic stability and prolonged symptom control, making it a cornerstone in modern cardioprotective therapy. Clinically validated for safety and efficacy, Ranol SR represents a critical advancement in long-term angina management.
Features
- Sustained-release formulation for 24-hour therapeutic coverage
- Active pharmaceutical ingredient: Ranolazine 500 mg or 1000 mg
- Modified-release tablet technology for gradual API dispersion
- Twice-daily dosing regimen for maintained plasma concentrations
- Bioavailability of approximately 76% under fed conditions
- Half-life of 7 hours for stable pharmacokinetic profile
- White to off-white, capsule-shaped, film-coated tablets
- Blister packaging in quantities of 60 tablets
- Storage stability at room temperature (15–30°C)
- Manufactured under cGMP compliance standards
Benefits
- Reduces frequency of angina episodes through sustained sodium channel modulation
- Improves exercise tolerance and functional capacity without significant hemodynamic effects
- Provides 24-hour myocardial protection through consistent drug plasma levels
- Minimizes nitrate dependence through complementary mechanism of action
- Enhances quality of life by allowing greater physical activity with reduced symptoms
- Demonstrates favorable safety profile with low risk of hypotension or bradycardia
Common use
Ranol SR is primarily indicated for the management of chronic stable angina pectoris in patients who have not achieved adequate response with other antianginal agents. It is particularly valuable as add-on therapy to beta-blockers, calcium channel blockers, or nitrates when additional angina control is required. The medication is commonly prescribed for patients with persistent symptoms despite conventional therapy, especially those with contraindications to or intolerance of other antianginal medications. Clinical applications extend to patients with microvascular angina and those with comorbidities where hemodynamic stability is paramount.
Dosage and direction
Initiate treatment with 500 mg twice daily, with or without food. Based on clinical response and tolerability, the dosage may be increased to a maximum of 1000 mg twice daily. Tablets should be swallowed whole with a glass of water; crushing, chewing, or splitting tablets alters the release profile and is contraindicated. Dose adjustments are recommended for patients with moderate to severe renal impairment (creatinine clearance <30 mL/min) or hepatic impairment. Elderly patients may require lower initial doses due to potential decreased clearance. Therapeutic effects are typically observed within two weeks of initiation.
Precautions
Monitor ECG parameters periodically, particularly QTc interval, though the risk of torsades de pointes is low at therapeutic doses. Use caution in patients with pre-existing QT prolongation or those taking other QT-prolonging drugs. Hepatic impairment requires dosage modification and close monitoring. Renal function should be assessed before initiation and periodically during treatment. Patients should be advised about potential dizziness and advised against operating machinery until response is established. Gradual dose titration is recommended to minimize gastrointestinal side effects. Pregnancy category C: use only if potential benefit justifies potential risk to fetus.
Contraindications
Hypersensitivity to ranolazine or any excipients in the formulation. Concomitant use with strong CYP3A4 inhibitors including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir. Severe hepatic impairment (Child-Pugh Class C). History of ventricular tachycardia or family history of congenital long QT syndrome. Concomitant administration with Class Ia or III antiarrhythmics. Use in patients with clinically significant hypotension (systolic BP <90 mmHg).
Possible side effects
Common (≥1/100 to <1/10): dizziness, constipation, nausea, headache. Uncommon (≥1/1,000 to <1/100): dry mouth, vomiting, abdominal pain, asthenia, peripheral edema. Rare (≥1/10,000 to <1/1,000): syncope, palpitations, tinnitus, blurred vision, hypotension. Very rare (<1/10,000): angioedema, leukopenia, thrombocytopenia. Most adverse reactions are mild to moderate and often diminish with continued therapy. Serious side effects requiring immediate medical attention include syncope, prolonged dizziness, or signs of blood dyscrasias.
Drug interaction
Strong CYP3A4 inhibitors contraindicated (increases ranolazine exposure 3-fold). Moderate CYP3A4 inhibitors (diltiazem, verapamil, erythromycin) require dose reduction. CYP3A4 inducers (rifampin, phenobarbital) may decrease efficacy. P-gp inhibitors (cyclosporine) may increase concentrations. Digoxin levels may increase by 1.5-fold; monitor levels. Simvastatin exposure increases approximately 2-fold; limit simvastatin to 20 mg daily. Metoprolol levels may increase by 80%; consider dose adjustment. Moderate interaction with antihypertensives may potentiate hypotension.
Missed dose
If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular twice-daily dosing schedule to ensure consistent therapeutic levels. If multiple doses are missed, contact healthcare provider for guidance on reinitiating therapy. Irregular dosing may compromise angina control and increase breakthrough symptom risk.
Overdose
Symptoms may include severe nausea, vomiting, drowsiness, syncope, hypotension, and QT prolongation. No specific antidote exists. Provide supportive care including ECG monitoring for at least 12 hours. Hemodialysis is unlikely to be effective due to high protein binding (62%). Manage hypotension with intravenous fluids and vasopressors if necessary. Gastric lavage may be considered if presentation is within 1 hour of ingestion. Contact poison control center for latest management recommendations.
Storage
Store in original blister packaging at room temperature (15–30°C). Protect from moisture and light. Keep out of reach of children and pets. Do not use if packaging is damaged or tablets show signs of deterioration. Discard any unused medication properly according to local regulations. Do not transfer tablets to other containers as humidity may affect stability. Shelf life is 36 months from manufacturing date when stored properly.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare provider before starting or changing any medication regimen. Dosage and suitability depend on individual patient factors. The manufacturer is not liable for incorrect use or self-medication. Report adverse events to appropriate regulatory authorities.
Reviews
Clinical trials demonstrate 60% reduction in angina frequency compared to placebo (p<0.001). Exercise tolerance improved by mean 45 seconds in treadmill testing. 78% of patients reported improved quality of life metrics in 12-week studies. Cardiologists note particular benefit in patients with refractory angina and diabetes mellitus. Real-world evidence supports maintained efficacy over 24-month follow-up with consistent safety profile. Patient satisfaction surveys indicate high adherence rates due to twice-daily dosing and minimal lifestyle interference.