Ranolazine-related dyspnea on exertion.
BACKGROUND
Ranolazine is increasingly being prescribed for the treatment of chronic stable angina. This report describes an adverse effect that may be related to ranolazine.


METHODS
A 77-year-old white man with chronic renal insufficiency was evaluated for moderate dyspnea on exertion (DOE). Cardiac and pulmonary workup revealed nonobstructive coronary artery disease and mild obstructive lung disease. The patient had been taking ranolazine 500 mg daily for possible angina for the past 2 months. Given the temporal association of his symptoms with drug initiation, ranolazine was discontinued during the hospitalization. One month after discontinuing ranolazine, the patient's DOE had completely resolved; the only intervention had been discontinuation of ranolazine. The patient's Naranjo algorithm score was 3, indicating a possible adverse drug reaction.


CONCLUSIONS
No previous cases of ranolazine-related DOE requiring drug cessation have been published. Ranolazine may be associated with DOE in this elderly man.
Department of Cardiology, Duke University Medical Center, Durham, North Carolina, USA. goswa001@mc.duke.edu
Robi
R
Goswami
David
D
Van De Car
Kenneth E
KE
Schmader
Thomas M
TM
Bashore
Michael H
MH
Sketch
D000083:Acetanilides / Q000009:adverse effects*; D000368:Aged; D004417:Dyspnea / Q000139:chemically induced* / Q000175:diagnosis* / Q000201:enzymology*; D004791:Enzyme Inhibitors / Q000009:adverse effects; D005080:Exercise Test / Q000379:methods; D006801:Humans; D008297:Male; D005082:Physical Exertion / Q000187:drug effects* / Q000502:physiology*; D010879:Piperazines / Q000009:adverse effects*; D000069458:Ranolazine
D000083:Acetanilides; D004791:Enzyme Inhibitors; D010879:Piperazines; D000069458:Ranolazine