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What Causes Restlessness At Night While On Ranexa?
Question: I have started taking Ranexa 500 twice daily but find it makes me restless at night interfering with sleep - would reducing the dosage to once daily (in the morning) stop its effectiveness against my (mild) stable angina when exercising?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that these are common adverse effects related to Ranexa.
But the minimal daily dose of Ranexa is 500 mg twice daily.
Reducing the dose to 500 mg once daily would no be safe, as it is not a therapeutic dose and it can not be used for chronic angina.
I would recommend consulting with your attending physician and discussing the possibility of switching to another therapy, different from Ranexa as you do not tolerate it's adverse effects.
You should know that therapies are modified based on diagnosis, individual characteristics and individual tolerance. There is not a determined therapy for one disorder.
I would like to have some more information on the other drugs you are taking, in order to be able to make some professional suggestions on the possible treatment options to optimize your therapy.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that these are common adverse effects related to Ranexa.
But the minimal daily dose of Ranexa is 500 mg twice daily.
Reducing the dose to 500 mg once daily would no be safe, as it is not a therapeutic dose and it can not be used for chronic angina.
I would recommend consulting with your attending physician and discussing the possibility of switching to another therapy, different from Ranexa as you do not tolerate it's adverse effects.
You should know that therapies are modified based on diagnosis, individual characteristics and individual tolerance. There is not a determined therapy for one disorder.
I would like to have some more information on the other drugs you are taking, in order to be able to make some professional suggestions on the possible treatment options to optimize your therapy.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Other drugs are Crestor 40, Lisinopril HCTZ 20.12.5, Aspirin 82... Betablocker (Lopressor) and Calcium Channel blocker (Cardizem) discontinued in past because not well tolerated (fatigue, nausea) hence Ranexa looked like good alternative.
If the restlessness, sleep interruption would eventually moderate/disappear I'd persevere with Ranexa as it definitely improves the exercise angina on hill walking.
For information, on recent stress test maximal heart rate (145) was achieved after 9 minutes for 10 METs with ischemic ECG changes (the S-T segment depression was between 2 and 3 mm when test discontinued) beginning at a heart rate of 122.
Many thanks.
If the restlessness, sleep interruption would eventually moderate/disappear I'd persevere with Ranexa as it definitely improves the exercise angina on hill walking.
For information, on recent stress test maximal heart rate (145) was achieved after 9 minutes for 10 METs with ischemic ECG changes (the S-T segment depression was between 2 and 3 mm when test discontinued) beginning at a heart rate of 122.
Many thanks.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Though the recommended dose of Ranexa is 500mg twice daily, facing your beneficial effects of this drug that you are experiencing, I would recommend reducing the dose to 250mg twice daily hoping that this will reduce concluded adverse effects, maintaining at the same time the desired pharmacological properties.
If such is not the case, then I would recommend you to stop Ranexa, switching to another rational alternative such as Trimetazidine 35mg twice daily with meals.
You should discuss with your prescribing doctor on the above mentioned issues.
Hope to have been helpful!
Regards,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
Though the recommended dose of Ranexa is 500mg twice daily, facing your beneficial effects of this drug that you are experiencing, I would recommend reducing the dose to 250mg twice daily hoping that this will reduce concluded adverse effects, maintaining at the same time the desired pharmacological properties.
If such is not the case, then I would recommend you to stop Ranexa, switching to another rational alternative such as Trimetazidine 35mg twice daily with meals.
You should discuss with your prescribing doctor on the above mentioned issues.
Hope to have been helpful!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Many thanks, very helpful. One last question; I'm assuming it's OK to cut my remaining 500mg pills in half - is it?
Brief Answer:
You are welcome!
Detailed Answer:
Hi,
You can just try the reduced dose and see if the desired therapeutic effect is maintained.
But, before switching to a reduced daily dose you have to discuss with your prescribing doctor.
Wishing you all the best!
Kind regards,
Dr. Iliri
You are welcome!
Detailed Answer:
Hi,
You can just try the reduced dose and see if the desired therapeutic effect is maintained.
But, before switching to a reduced daily dose you have to discuss with your prescribing doctor.
Wishing you all the best!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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