Understanding Ranolazine and EECP® Side Effects and Safety

Ranolazine and EECP are both used for patients with chronic stable angina. Learn the difference between both.

Chronic Stable Angina affects more than 10 million people in the US. Despite being on appropriate medications, patients may continue to experience chest pain. Individuals who continue to experience angina despite optimized medical therapy may be prescribed ranolazine or referred to Enhanced External Counterpulsation (EECP). This article provides a quick synopsis of their side effects and benefits side-by-side.  

What is Ranolazine?

Ranolazine/Ranexa is a prescription medication (antianginal) typically added to existing medications used for patients who continue to experience chest pain. Ranolazine/Ranexa should be taken as prescribed to experience any possible benefits. 

What are some of the side effects with Ranolazine? 

Common side effects with Ranolazine/Ranexa include: 

• Dizziness
• Nausea
• Headache
• Constipation
• Lack of energy

Call your doctor at once if you have: 

• Light-headed feeling, like you might pass out
• Fast or pounding heartbeats, fluttering in your chest
• Kidney problems: little or no urination, painful urination, swelling in your feet or ankles, feeling tired or short of breath

What is EECP?

Enhanced External Counterpulsation (EECP) is a non-invasive, FDA approved, outpatient therapy to reduce the intensity and frequency of angina related chest pain. Treatment is administered through three pairs of external cuffs that are applied around the calves, thighs and buttocks. The cuff inflation and deflation are synchronized with the heartbeat using an electrocardiograph (ECG) machine. 

EECP increases blood flow to the heart, while simultaneously stimulating the opening and formation of collaterals (small branches of blood vessels around the heart) to create a natural bypass around narrowed or blocked arteries.

Common side effects with EECP:

• Skin bruising/abrasion
• Back and leg pain*

_{*this may be resolved after a few EECP therapy sessions}

How do the benefits of Ranolazine and EECP compare?

Although there are no clinical trials studying EECP and Ranexa in a head-to-head trial, new evidence comparing the two options for patients with angina suggests:

• 85% of patients who undergo EECP experience an improvement with angina, compared to 15% with Ranexa
• EECP patients see an increase in their walking distance twice the increase seen with Ranexa
• Angina frequency is reduced by ~5 episodes a week compared to 2.3 episodes/week with Ranexa
• Quality of life improvements are comparable between EECP and Ranexa

Should I get Ranolazine or EECP? 

While both are viable options, it is important to consult with your doctor about what may be best for you based on other medical conditions, medications and allergies. Considering the safety and benefits of both options, some doctors will start patients on EECP, and then decide if Ranexa is even warranted. 

DISCLAIMER: The information on this blog is for general information only. It should not be considered medical advice. Please consult with your doctor regarding any medical decisions about your health.