From the Guidelines
Patients who experience headaches on Ranexa (ranolazine) may also experience similar symptoms with Imdur (isosorbide mononitrate), but the likelihood is independent of their reaction to Ranexa due to different mechanisms of action. Imdur is a nitrate that commonly causes headaches as a side effect due to its vasodilatory properties, affecting approximately 25-40% of patients 1. Ranexa, which treats angina by inhibiting the late sodium current in cardiac cells, causes headaches less frequently (about 5-6% of patients) 1. The headache mechanism differs between these medications: Imdur-related headaches result from cerebral vasodilation, while Ranexa-related headaches likely stem from other mechanisms.
Key Considerations
- The most recent and highest quality study on ranolazine, published in 2018, suggests that ranolazine is effective in reducing symptoms of chronic stable angina, but does not improve outcomes of patients with chronic stable angina 1.
- Imdur, as a nitrate, has a different mechanism of action and side effect profile compared to Ranexa, which may affect the likelihood of headaches in patients switching from one medication to the other.
- Patients who experience headaches with Ranexa should be monitored closely when starting Imdur, as the likelihood of nitrate-induced headaches is independent of reactions to other medications.
Recommendations
- Patients should report severe or persistent headaches to their healthcare provider, who may adjust dosing schedules or recommend preventive measures like taking the medication with food or using over-the-counter pain relievers as needed.
- Healthcare providers should be aware of the different mechanisms of action and side effect profiles of Ranexa and Imdur when switching patients between these medications, and monitor patients closely for adverse effects.
From the FDA Drug Label
As with other nitrates, daily headaches sometimes accompany treatment with isosorbide mononitrate In patients who get these headaches, the headaches are a marker of the activity of the drug.
The FDA drug label does not directly answer whether patients who experience headaches on Ranexa will have similar symptoms with Imdur. However, it does mention that headaches are a possible side effect of isosorbide mononitrate, and that they can be a marker of the activity of the drug.
- It is not possible to draw a conclusion about the relationship between headaches caused by Ranexa and Imdur based on the provided information 2, 2.
From the Research
Similar Symptoms with Imdur
- There is no direct evidence to suggest that patients who experience headaches on Ranexa (ranolazine) will have similar symptoms with Imdur (isosorbide mononitrate) 3, 4, 5, 6, 7.
- The provided studies focus on the efficacy and adverse effects of antipsychotics, isosorbide mononitrate, and nitrate therapy, but do not specifically address the relationship between Ranexa and Imdur 3, 4, 5, 6.
- However, it is known that nitrates like isosorbide mononitrate can cause headaches as a side effect, but this is not directly related to the use of Ranexa 4, 5, 6.
- Understanding the pharmacology of side effects and the mode of action of medicines can help predict and prevent adverse drug reactions, but more specific research is needed to determine the relationship between Ranexa and Imdur 7.
Adverse Effects of Nitrates
- Nitrates like isosorbide mononitrate can cause headaches, but the incidence and severity of this side effect can vary depending on the individual and the specific formulation of the medication 4, 5, 6.
- Other factors such as age, gender, and concomitant medical conditions can also influence the risk and severity of adverse effects, including headaches 6.
- Healthcare professionals should be aware of these potential adverse effects and monitor patients closely when prescribing nitrates like Imdur 4, 5, 6, 7.