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Editor's Correspondence
June 26, 2006

Mechanism of Action of Ranolazine

Arch Intern Med. 2006;166(12):1325-1326. doi:10.1001/archinte.166.12.1325-b

The article by Nash1 titled “The Case for Medical Treatment in Chronic Stable Coronary Artery Disease” in the December 12/26, 2005 issue of the ARCHIVES cited a mechanism for ranolazine that is not consistent with current data regarding the antianginal effects of ranolazine therapy.

Several mechanisms have been previously proposed.2,3 Although ranolazine was shown to have partial fatty acid oxidase inhibitor activity in preclinical investigations,2,3 it occurs at concentrations far above those achieved in recent clinical trials demonstrating therapeutic benefit and is probably not the primary mechanism for clinical efficacy.3-5

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