The mechanism of action described in the labeling for Ranexa (ranolazine extended-release tablets, from CV Therapeutics) has been updated to describe the ability of ranolazine to inhibit the late sodium current at therapeutic levels. During ischemic episodes, excess sodium can flow into cardiac cells through sodium channels and may trigger a subsequent overload of calcium. Calcium overload can cause problems with proper contraction and relaxation of the heart. Inhibition of the late sodium current has been shown to improve mechanical and electrical dysfunctions of cardiac cells under these circumstances.

Ranexa is currently indicated for the treatment of chronic angina in patients who have not achieved an adequate response with other antianginal drugs and should be used in combination with amlodipine, beta-blockers or nitrates.

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