Ranolazine Use in ESRD Patients on Hemodialysis

Clinical Considerations

The American Heart Association recommends ranolazine for chronic stable angina, which can be used in combination with amlodipine, beta-blockers, or nitrates, with a potential benefit in ESRD patients with hemodynamic instability 1, 2
Ranolazine's antianginal effect does not depend on changes in heart rate or blood pressure, making it potentially useful in ESRD patients with hemodynamic instability, and was associated with reduced recurrent ischemia in patients with prior chronic angina in the MERLIN-TIMI trial 1

Regular monitoring of the QTc interval is recommended, as ranolazine prolongs the QTc interval in a dose-related manner 1