Abstract
MULTIPLE ROLES OF RANOLAZINE BEYOND ANGINA PECTORIS

Karwanje Pratik M.*, Bhawar Sanjay B. and Kakad Sudarshan B.

ABSTRACT

Ranolazine is a piperazine derivative accepted as an antianginal drug. Principally it is used as a second line antianginal in stable coronary artery disease. Ranolazine blocks the late Na + current and prevents the rise of cytosolic calcium. It decreases myocardial wall tension and improves coronary blood flow. Ranolazine is effective in atrial fibrillation (AF) as an appendage to electrical or pharmacological cardio version. It can be used in permutation with amiodarone, metoprolol or dronedarone. It has also been used in AF arising after coronary artery bypass grafting surgery. Role of ranolazine is also being evaluated in pulmonary arterial hypertension, diastolic dysfunction, and chemotherapy induced cardio toxicity. Ranolazine has some antiglycemic effect and has shown a reduction of hemoglobin A1C in several trials. The antianginal effect of ranolazine has also been seen to be more in patients with diabetes compared to those without diabetes. Ranolazine is being evaluated in patients with the peripheral arterial disease with discontinuous claudication and hypertrophic cardiomyopathy. Pilot studies have shown that Ranolazine may be beneficial in neurological conditions with myotonia. The evidence base on the use of ranolazine in various circumstances is rapidly increasing with results of further trials readily awaited. Accumulating verification may see Ranolazine in schedule clinical use for many conditions beyond its traditional role as an antianginal.

Keywords: Ranolazine, angina, anti ischemic.


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