We think we may have uncovered the recent cause of my dizzy spells which include,  on occasion, passing out,  and a weird desire to vomit although feeling ok otherwise.

In preparation for my heart procedure at the end of the month, my cardiologist prescribed two additional drugs, one of which is Ranolazine TAB 500MG ER. See for yourself what Perplexity has to say. This may be the cause.

Ranolazine is an extended-release medication primarily used to treat chronic angina (chest pain) in patients with coronary artery disease. The 500 MG ER (extended-release) tablet is one of the common formulations of this drug. Here’s a detailed overview of ranolazine, with a focus on its side effects, particularly dizziness and vomiting:

Mechanism of Action

Ranolazine works by affecting sodium and calcium channels in the heart, which helps improve blood flow to the heart muscle and reduces the workload on the heart[1]. This mechanism allows it to alleviate angina symptoms without significantly affecting heart rate or blood pressure.

Side Effects

While ranolazine can be effective in managing chronic angina, it may cause various side effects. Two of the more common and notable side effects are dizziness and vomiting:

Dizziness

Dizziness is one of the most frequently reported side effects of ranolazine:

  • Prevalence: Approximately 6.2% of patients taking ranolazine experience dizziness[2].
  • Characteristics: The dizziness may manifest as a light-headed feeling or a sensation of spinning (vertigo)[1][3].
  • Onset: It can occur shortly after starting the medication or after increasing the dose[3].
  • Severity: Dizziness is often dose-related, meaning higher doses may increase the likelihood or severity of this side effect[3].
  • Management: If dizziness persists or becomes severe, patients should consult their healthcare provider. In some cases, dose adjustment may be necessary[1].

Vomiting

While less common than dizziness, vomiting is another potential side effect of ranolazine:

  • Prevalence: Vomiting is less frequent than nausea, which affects about 4.4% of patients[2].
  • Characteristics: Vomiting may be accompanied by nausea and can range from mild to severe[1][3].
  • Risk factors: High doses of ranolazine can increase the likelihood of vomiting[3].
  • Management: If vomiting persists or is severe, medical attention should be sought. Staying hydrated and taking the medication with food may help alleviate this side effect[1].

Other Common Side Effects

Besides dizziness and vomiting, other frequently reported side effects of ranolazine include:

  • Headache (5.5% of patients)
  • Constipation (4.5% of patients)
  • Nausea (4.4% of patients)[2]

Serious Side Effects

While less common, ranolazine can potentially cause more serious side effects, including:

  • QT prolongation (a heart rhythm disorder)
  • Kidney problems
  • Allergic reactions[1][3]

Precautions and Interactions

Ranolazine interacts with various medications and should not be taken with certain drugs, including some antifungals, HIV medications, and antibiotics[1]. It’s also important to avoid consuming grapefruit or grapefruit juice while taking ranolazine, as this can increase the drug’s concentration in the blood[6].

Dosage and Administration

The typical starting dose of ranolazine is 500 mg twice daily, which may be increased to 1000 mg twice daily as needed. The medication should be taken with or without food and swallowed whole, not crushed or chewed[1].

In conclusion, while ranolazine 500 MG ER can be an effective treatment for chronic angina, patients should be aware of potential side effects, particularly dizziness and vomiting. It’s crucial to follow the prescribed dosage and report any persistent or severe side effects to a healthcare provider promptly.

Citations:
[1] https://www.drugs.com/mtm/ranolazine.html
[2] https://www.rxlist.com/ranexa-drug.htm
[3] https://www.ncbi.nlm.nih.gov/books/NBK507828/
[4] https://www.drugs.com/sfx/ranolazine-side-effects.html
[5] https://www.buzzrx.com/ranolazine-er/side-effects
[6] https://www.webmd.com/drugs/2/drug-94984-2425/ranolazine-oral/ranolazine-extended-release-granules-oral/details
[7] https://medlineplus.gov/druginfo/meds/a606015.html