Ranolazine is believed to have its effects via altering the transcellular late sodium current. It affects the sodium-dependent calcium channels during myocardial ischemia in rabbits by altering the intracellular sodium level. Thus, ranolazine indirectly prevents the calcium overload that causes cardiac ischemia in rats. Ranolazine is indicated for the treatment of chronic angina; it may be used in combination with beta blockers, nitrates, calcium channel blockers, antiplatelet therapy, lipid-lowering therapy, ACE inhibitors, and angiotensin receptor blockers. It has been shown to decrease angina episodes in individuals with coronary artery disease on maximal doses of amlodipine.[9] In addition, it has been shown to both decrease angina episodes and increase exercise tolerance in individuals taking concomitant atenolol, amlodipine, or diltiazem.
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