CardioSource WorldNews - Page 35

April 19 10th Annual Cardiovascular Update & 54th Annual Carl J. Wiggers Memorial Lecture The Ritz-Carlton Cleveland, OH Chronic angina may be holding him back For patients limiting their activity due to chronic angina, adding Ranexa® may help In the Phase 3 CARISA trial1 Ranexa 1000 mg BID,* when added to a beta-blocker or calcium channel blocker,† was superior to those treatments plus placebo at: Increasing exercise duration (24 secs change vs placebo from baseline at Week 12) Increasing the time to onset of ischemia during exercise testing at peak plasma concentrations (94 vs 59 secs) Decreasing angina frequency (2.1 vs 3.3 avg/wk) Decreasing nitroglycerin use (1.8 vs 3.1 avg doses/wk) Learn how Ranexa may help your patients get back on track BID = twice daily *Limit the dose of Ranexa to 500 mg BID when coadministered with diltiazem, verapamil, or other moderate CYP3A inhibitors. † CARISA TRIAL DESIGN: CARISA (Combination Assessment of Ranolazine In Stable Angina) was a doubleblind, randomized, placebo-controlled clinical trial of 823 patients with chronic angina who received Ranexa 750 mg BID (n = 272), Ranexa 1000 mg BID (n = 261), or placebo (n = 258) for 12 weeks (note, 750 mg is not an approved dose). At the physician’s discretion, patients received either atenolol 50 mg, amlodipine 5 mg, or diltiazem 180 mg once daily as required background antianginal therapy. Sublingual nitrates were used as needed. Corresponding P-values < 0.05.1 Please see following page for brief summary of full Prescribing Information. daily, based on clinical symptoms. Ranexa should be swallowed whole; do not crush, break or chew. Limit the dose of Ranexa to 500 mg twice daily in patients on moderate CYP3A inhibitors (e.g., diltiazem, verapamil, erythromycin, fluconazole, and grapefruit juice or grapefruit-containing products). See Drug Interactions for additional dosing considerations. Drug Interactions Inducers and strong inhibitors of CYP3A: Do not use Ranexa (see Contraindications). Moderate CYP3A inhibitors: Limit Ranexa to 500 mg twice daily (see Dosage and Administration). P-gp inhibitors (e.g., cyclosporine): Ranexa exposure increased; titrate Ranexa based on clinical response. CYP3A substrates: Limit simvastatin to 20 mg once daily when used with Ranexa. Doses of other sensitive CYP3A substrates (e.g., lovastatin) and CYP3A substrates with narrow therapeutic range (e.g., cyclosporine, tacrolimus, sirolimus) may need to be reduced with Ranexa. Drugs transported by P-gp (e.g., digoxin) or metabolized by CYP2D6 (e.g., tricyclic antidepressants and antipsychotics): Doses of these drugs may need to be reduced. Drugs transported by OCT2: Limit metformin to 1700 mg per day when used with Ranexa 1000 mg twice daily. Monitor blood glucose and risks associated with high metformin exposure. Reference: 1. Chaitman BR, Pepine CJ, Parker JO, et al. Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized controlled trial. JAMA. 2004;291:309-316. Ranexa is a registered trademark of Gilead Sciences, Inc. ©2016 Gilead Sciences, Inc. All rights reserved. RANP0417 07/16