Introduction About XEMNOL SR 500 TABLET

XEMNOL SR 500 TABLET contains Ranolazine, a medicine used in the management of chronic angina (chest pain). It works by improving blood flow to help the heart work more efficiently. It is especially helpful for individuals who continue to experience chest pain despite being on other heart medications or for those who cannot tolerate traditional options due to blood pressure or heart rate concern. 

XEMNOL SR 500 TABLET works by improving the heart’s energy efficiency. Instead of lowering blood pressure or heart rate, it acts on specific sodium channels in the heart muscle to reduce excess sodium and calcium buildup. This allows the heart to relax better and function more efficiently, particularly during physical activity or emotional stress. 

Clinical studies have shown that patients taking Ranolazine experienced fewer angina attacks and better exercise tolerance, making it suitable for long-term use under medical supervision.

XEMNOL SR 500 TABLET should be swallowed whole with water and can be taken with or without food. Patients with moderate to severe kidney problems or liver impairment should use this medicine with caution. Regular monitoring of kidney function may be advised for those with reduced kidney clearance (CrCl <60 mL/min).

Pregnant or breastfeeding women should use XEMNOL SR 500 TABLET only if clearly needed and prescribed by a doctor, as there is limited data on its safety in these populations. Common side effects include dizziness, constipation, nausea, and headache. If you experience severe symptoms like fainting, fast or irregular heartbeat  seek medical attention immediately. 

Always inform your healthcare provider about all the medications you are taking, as XEMNOL SR 500 TABLET can interact with certain drugs, including antifungals, antibiotics, and medications for seizures or heart rhythm problems.

Uses Of XEMNOL SR 500 TABLET

• Reduces frequency and severity of angina attacks
• Enhances left ventricular diastolic function
• Improves exercise tolerance in heart patients

Benefits of XEMNOL SR 500 TABLET

XEMNOL SR 500 TABLET: A Medication for Reducing Angina Frequency

• XEMNOL SR 500 TABLET is specifically formulated to help reduce the frequency of painful anginal episodes, allowing patients to go about their daily activities with greater ease.
• Unlike traditional angina treatments that focus primarily on lowering blood pressure or improving blood flow, XEMNOL SR 500 TABLET works by targeting the underlying mechanisms of heart muscle energy dysfunction. 
• Clinical studies have shown that XEMNOL SR 500 TABLET effectively reduces the number of angina attacks by improving the efficiency of the heart muscle and preventing the imbalance of sodium ions that contribute to angina. 

XEMNOL SR 500 TABLET for Improving Exercise Tolerance in Angina Patients

• For individuals with chronic angina, simple physical activities, like walking or climbing stairs, can trigger painful symptoms. XEMNOL SR 500 TABLET has been shown to improve exercise tolerance in angina patients by helping the heart use oxygen more efficiently, particularly during physical exertion.
• Several clinical studies have demonstrated that XEMNOL SR 500 TABLET allows patients to engage in physical activities longer and with less discomfort. This makes it an invaluable medication for improving a patient's ability to participate in exercise and physical therapy.
• By reducing the impact of exercise-induced angina, XEMNOL SR 500 TABLET supports an active lifestyle and enhances overall cardiovascular endurance.

Role of XEMNOL SR 500 TABLET in Enhancing Quality of Life for Angina Sufferers

• XEMNOL SR 500 TABLET has been shown to improve the quality of life for those suffering from chronic angina by minimizing the number of angina episodes, especially those triggered by physical activity or stress.

XEMNOL SR 500 TABLET: Benefits Beyond Heart Pain Relief

• XEMNOL SR 500 TABLET also plays a role in improving the overall function of the heart muscle by enhancing its energy efficiency. This unique action helps support heart function even during stressful conditions, reducing the risk of further complications related to angina.
• In addition, XEMNOL SR 500 TABLET does not significantly lower blood pressure or heart rate, making it suitable for individuals who may have already been prescribed medications for these issues. Often used in combination with traditional angina medications to provide comprehensive heart support without unwanted side effects like dizziness or fatigue.

Safe for Diabetics: The Advantages of XEMNOL SR 500 TABLET in Diabetes and Angina

• XEMNOL SR 500 TABLET offers a unique advantage as it is considered safe for use in diabetic patients. Research indicates that XEMNOL SR 500 TABLET does not have significant adverse effects on blood sugar levels, which is a common concern with many medications used to manage heart conditions.

Long-Term Benefits of XEMNOL SR 500 TABLET in Managing Chronic Angina

• One of the most notable benefits of XEMNOL SR 500 TABLET is its ability to provide long-term relief from chronic angina. Unlike some medications that may lose their effectiveness with prolonged use, XEMNOL SR 500 TABLET maintains its efficacy, providing patients with lasting control over their symptoms.
• Additionally, XEMNOL SR 500 TABLET helps reduce the strain on the heart, allowing the heart muscle to function more efficiently. 

How XEMNOL SR 500 TABLET Works

How does XEMNOL SR 500 TABLET work for chest pain?

• XEMNOL SR 500 TABLET (Ranolazine) helps reduce chest pain (angina) by improving how your heart uses energy, especially during physical activity or stress. It controls certain signals in heart cells (called late sodium currents) that can make the heart overwork and cause discomfort.
• By lowering stress on the heart, XEMNOL SR 500 TABLET reduces how often and how strongly chest pain happens, especially during activity. It works without slowing down your heart rate or lowering blood pressure, making it a good choice with other heart medications.

Understanding Ranolazine's Effect on Heart Function:

• Ranolazine supports better heart function by helping heart muscles relax and work more smoothly. It reduces calcium overload in heart cells which helps the heart beat more efficiently without straining.
• This makes it easier for your heart to work when oxygen is low like during exercise or emotional stress. Over time, Ranolazine improves exercise ability and reduces discomfort, helping you stay more active.

How to use XEMNOL SR 500 TABLET

• Starting Dose: Begin with 500 mg twice daily.
• Maintenance Dose: If needed, your doctor may increase the dose to 1000 mg twice daily based on your condition.
• Administration: Swallow the tablet whole with a glass of water. Do not crush, chew, or break it
• With or Without Food: You can take XEMNOL SR 500 TABLET with or without food

Recommended Dosage of XEMNOL SR 500 TABLET

• Initial Dose: 500 mg twice a day.
• Maximum Dose: The maximum recommended daily dose is 1000 mg twice daily.
• Adjustments: Your doctor may adjust the dosage based on your response and any side effects.

How often should I take XEMNOL SR 500 TABLET?

• Frequency: Take XEMNOL SR 500 TABLET twice daily, once in the morning and once in the evening.
• Consistency: Try to take it at the same times each day to help remember

Can I take XEMNOL SR 500 TABLET with or without food? 

• Flexibility:  You can take XEMNOL SR 500 TABLET with or without food.
• Recommendation: Taking it with food may help reduce any potential stomach discomfort.

What if I forgot to take XEMNOL SR 500 TABLET

• Missed Dose: If you miss a dose, take it as soon as you remember.
• Next Dose: If it's almost time for your next dose, skip the missed dose.
• Avoid Doubling: Do not take two doses at the same time to make up for a missed dose

Overdose

• Symptoms: Taking more than the prescribed dose may cause symptoms like dizziness, nausea, vomiting, blurred vision, or fainting.
• Action: If you suspect an overdose, seek medical attention immediately.

Side Effects Of XEMNOL SR 500 TABLET

Like all medicines XEMNOL SR 500 TABLET may cause certain side effects in some individuals, although not everybody gets them.

Common Side Effects of XEMNOL SR 500 TABLET

• nausea, vomiting
• constipation
• dizziness
• headache
• weakness

Neurological Effects and Dizziness from XEMNOL SR 500 TABLET

XEMNOL SR 500 TABLET (ranolazine) may cause neurological side effects in some patients due to its action on the central nervous system. These effects are generally mild, but in some cases may become bothersome or signal the need for medical review.

Reported neurological side effects include:

• Dizziness or light-headedness, especially when standing
• Headache
• Lack of concentration or confusion
• Tingling sensation (paresthesia)

Impact of XEMNOL SR 500 TABLET on Heart Rhythm and QT Interval

XEMNOL SR 500 TABLET has been associated with QT interval prolongation, a change in heart rhythm that can increase the risk of irregular heartbeats (arrhythmias). This is a rare but potentially serious side effect that requires medical monitoring.

Cardiac-related side effects may include:

• Palpitations (feeling your heart racing or skipping beats)
• Abnormal ECG (electrocardiogram) findings
• Fast or irregular heartbeat
• Chest discomfort or shortness of breath

Effects of XEMNOL SR 500 TABLET on Sleep and Mental Clarity

Some patients may notice cognitive or sleep-related side effects while taking XEMNOL SR 500 TABLET. These effects are usually mild but can interfere with daily functioning in sensitive individuals.

Possible effects on mental clarity and sleep:

• Insomnia or difficulty falling asleep
• Vivid dreams or restlessness at night
• Feeling mentally foggy or “out of it” during the day
• Mood swings or irritability

When to Seek Medical Attention?

Stop taking XEMNOL SR 500 TABLET and contact your doctor immediately if you experience any of the following side effects:

• Symptoms of angioedema or allergic reaction such as hives, swelling of the face, tongue or throat causing difficulty in breathing or swallowing
• If you feel your heartbeat is abnormal, too fast or fluttering
• Sleep disturbances or brain fog persist for more than a few days and impacts daily quality of life

Warning & Precautions

Pregnancy

Use with Caution

XEMNOL SR 500 TABLET should be used during pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the fetus. There are limited human studies available on the use of Ranolazine during pregnancy. Animal studies have shown adverse effects at high doses. Always consult a doctor before starting Ranolazine if you are pregnant or planning to become pregnant

Breastfeeding

Consult your doctor

It is unknown whether Ranolazine is excreted in human breast milk. Potential harm to the nursing infant cannot be ruled out. A decision should be made whether to discontinue breastfeeding or discontinue the drug, taking into account the importance of the medicine to the mother. Avoid use while breastfeeding unless prescribed with close monitoring

Driving and Using Machines

Use with Caution

Do not drive or operate any machines if you feel dizziness, lightheadedness, faintness, blurred vision, confusion, hallucination, double vision and coordination problems after taking XEMNOL SR 500 TABLET

Kidney

Use with Caution

XEMNOL SR 500 TABLET should be used with caution in patients with severe kidney impairment (creatinine clearance <30 mL/min). Increased risk of adverse effects due to accumulation of the drug in renal dysfunction. Renal function should be assessed before and during treatment, especially in elderly patients. Dose adjustment may be required; always follow the prescriber's instructions.

Liver

Contraindicated

XEMNOL SR 500 TABLET is not recommended in patients with moderate to severe liver dysfunction. The studies have shown that Ranolazine gets extensively metabolized in the liver hence Impaired function can lead to elevated drug levels and increased risk of side effects, especially QT prolongation.

Allergy

Contraindicated

Do not take XEMNOL SR 500 TABLET if you are allergic to Ranolazine or to lactose or other sugars or to any other ingredients of this medicine.

Heart Disease

Use with Caution

XEMNOL SR 500 TABLET should be used with caution in patients with moderate to severe heart failure, abnormal ECG changes like QT prolongation or long QT syndrome. Contact your doctor before taking XEMNOL SR 500 TABLET

Use In Pediatrics

Contraindicated

XEMNOL SR 500 TABLET is not recommended for use in children and adolescents under 18 years of age. Contact your doctor before taking XEMNOL SR 500 TABLET

Use In Geriatrics

Use with Caution

XEMNOL SR 500 TABLET should be used with caution in elderly patients aged 65 years or above.  Contact your doctor before taking XEMNOL SR 500 TABLET

Who should not take [GBNKEYWORD

XEMNOL SR 500 TABLET is not recommended for use if you have:

• rare hereditary problems like galactose intolerance, the Lapp lactase deficiency and glucose-galactose malabsorption

Safety Advice

Doctor’s Tip On Effective Use of XEMNOL SR 500 TABLET For Maximum Benefits:

To get the most out of XEMNOL SR 500 TABLET (Ranolazine), patients should not only take the medication as prescribed but also make a few smart lifestyle adjustments. Below are expert-backed tips that can enhance effectiveness and reduce the risk of side effects:

Medication Tips for Best Results:

• Take it at the same time daily to maintain consistent levels in your body.
• Do not crush or chew the tablet – it’s an extended-release formula.
• Avoid grapefruit juice as it can interfere with how your body processes the drug.
• Report any dizziness, chest pain, or heart rhythm changes to your doctor immediately.
• Do not self-adjust the dose. Always follow the doctor’s instructions. 

Is XEMNOL SR 500 TABLET Safe for Long-Term Use?

Yes, XEMNOL SR 500 TABLET is considered safe for long-term use in most patients with chronic stable angina. It has a favorable safety profile and is often used when first-line treatments are not enough. However:

• Regular checkups (including ECG and kidney/liver tests) are important.
• It should be used with caution in elderly patients or those with multiple medications due to potential drug interactions.
• Long-term safety is enhanced when the medication is combined with healthy lifestyle habits and monitored by a physician.

Diet and Lifestyle Advice

Diet & Lifestyle Advice for Heart Patients

• Limit salt intake to control blood pressure.
• Choose whole grains, fruits, vegetables, lean proteins, and healthy fats like olive oil or nuts.
• Avoid processed and fried foods, as they may increase cholesterol.
• Stay hydrated and reduce caffeine if it triggers palpitations.
• Quit smoking and limit alcohol to improve heart function and overall health.

Exercise Recommendations for Patients on XEMNOL SR 500 TABLET

• Start slow and build gradually – walking, light cycling, or swimming are great low-impact options.
• Aim for at least 30 minutes of moderate activity 5 days a week, unless advised otherwise.
• Always warm up and cool down to protect your heart and joints.
• Avoid high-intensity workouts that strain the heart, especially if angina is still present.
• Stop immediately and seek help if you feel chest pain, shortness of breath, or dizziness during exercise.

Is this tablet habit-forming?

• No, XEMNOL SR 500 TABLET(Ranolazine) is not habit-forming or addictive.
• It does not cause dependence or withdrawal symptoms.
• It works by improving blood flow to the heart, not by affecting brain chemicals like addictive drugs.
• It is considered safe for long-term use under medical supervision for managing chronic angina.

Drug - Drug interaction

Strong CYP3A Inhibitors (e.g., Ketoconazole, Clarithromycin, Ritonavir)

• Risk: Significantly increases XEMNOL SR 500 TABLET levels → risk of QT prolongation, dizziness, and arrhythmias.
• Management: Avoid use together. If essential, consider alternative medication or lower XEMNOL SR 500 TABLET dose under supervision.

CYP3A Inducers (e.g., Rifampicin, Phenytoin, Carbamazepine)

• Risk: Decreases XEMNOL SR 500 TABLET blood concentration → reduced therapeutic effect.
• Management: Avoid combining. Use an alternative angina treatment if inducers are required.

XEMNOL SR 500 TABLET and Digoxin interaction

• Risk: XEMNOL SR 500 TABLET may increase digoxin levels, leading to toxicity (nausea, vision changes, arrhythmia).
• Management: Monitor digoxin levels and adjust dose if needed. Watch for signs of toxicity.

Diltiazem and Verapamil (moderate CYP3A inhibitors)

• Risk: May increase XEMNOL SR 500 TABLET plasma levels → dizziness, hypotension, or QT prolongation.
• Management: Use lowest effective XEMNOL SR 500 TABLET dose; monitor for side effects.

XEMNOL SR 500 TABLET and Tricyclic Antidepressants

• Risk: Increase XEMNOL SR 500 TABLET levels via CYP2D6 inhibition → heightened CNS side effects and QT risk.
• Management: Use with caution; monitor ECG and symptoms.

Simvastatin (≥20 mg/day)

• Risk: Increases statin levels → risk of muscle damage or rhabdomyolysis.
• Management: Do not exceed 20 mg/day of simvastatin. Consider switching to pravastatin or rosuvastatin if needed.

Antiarrhythmic Drugs (e.g., Amiodarone, Sotalol)

• Risk: Combined use may amplify QT prolongation, leading to serious arrhythmias.
• Management: Careful ECG monitoring required. Avoid combination in high-risk cardiac patients.

Metformin

• Risk: XEMNOL SR 500 TABLET may inrease metformin blood levels.
• Management: Limit metformin dose to ≤1700 mg/day if used with XEMNOL SR 500 TABLET. Monitor blood glucose and renal function.

Drug - Food interaction

XEMNOL SR 500 TABLET and Grapefruit Juice: Avoidance and Risks

XEMNOL SR 500 TABLET(Ranolazine) should not be taken with grapefruit or grapefruit juice. This combination can lead to potentially harmful effects due to how both substances interact in the body.

Potential Risks of Taking XEMNOL SR 500 TABLET with Grapefruit Juice

• Increased risk of side effects such as dizziness, headache, constipation, and nausea
• Heightened risk of QT interval prolongation, which may lead to serious heart rhythm abnormalities
• Potential for toxicity due to excessive accumulation of the drug

What You Should Do:

• Avoid grapefruit juice and fresh grapefruit entirely while taking XEMNOL SR 500 TABLET.
• Check ingredient labels of fruit blends or juices for grapefruit content.
• Inform your doctor if you’ve consumed grapefruit while on XEMNOL SR 500 TABLET—dose adjustments or monitoring may be needed.

FAQs About XEMNOL SR 500 TABLET

Q: What is XEMNOL SR 500 TABLET used for?

A: XEMNOL SR 500 TABLET is prescribed to manage chronic angina pectoris, a condition characterized by chest pain due to reduced blood flow to the heart muscle. It helps improve exercise tolerance and reduce the frequency of angina attacks. XEMNOL SR 500 TABLETis typically used in combination with other anti-anginal therapies when these alone do not provide adequate control.

Q: How does XEMNOL SR 500 TABLET help with chest pain?

A: XEMNOL SR 500 TABLET works by inhibiting late sodium currents in heart muscle cells, reducing calcium overload and improving myocardial relaxation. This mechanism helps decrease the heart's oxygen demand and enhances blood flow, thereby alleviating angina symptoms.

Q. How long does it take for XEMNOL SR 500 TABLETto work?

A: XEMNOL SR 500 TABLET typically reaches its peak effect within 4 hours after ingestion. However, individual responses may vary, and it may take several days to observe the full therapeutic benefits.

Q: Does XEMNOL SR 500 TABLET cause dizziness or nausea?

A: Yes, common side effects of XEMNOL SR 500 TABLET include dizziness, nausea, constipation, headache, blurred vision, dry mouth, and stomach pain. These side effects are generally mild and may subside as your body adjusts to the medication.

Q: Does XEMNOL SR 500 TABLET lower heart rate or blood pressure?

A: XEMNOL SR 500 TABLET does not significantly affect heart rate or blood pressure. It works by improving myocardial oxygen supply and demand balance without directly altering these parameters.

Q: What are the side effects of XEMNOL SR 500 TABLET?

A: In addition to dizziness and nausea, other potential side effects include:

• Tinnitus (ringing in the ears)
• Fatigue or weakness
• Blurred vision
• Constipation
• Dry mouth
• Stomach pain

Serious side effects are rare but may include QT prolongation, which can lead to irregular heartbeats. Regular monitoring is advised.

Q: Can I consume alcohol while taking XEMNOL SR 500 TABLET?

A: Alcohol may exacerbate side effects such as dizziness and drowsiness. It is advisable to limit alcohol intake or avoid it while taking XEMNOL SR 500 TABLET

Q: Is it safe to take XEMNOL SR 500 TABLET during pregnancy?

A: XEMNOL SR 500 TABLET should be used during pregnancy only when clearly needed. Animal studies have shown harmful effects on the developing fetus, and there are no adequate studies in pregnant women. Consult your doctor to weigh the potential risks and benefits.

Q: Does XEMNOL SR 500 TABLET affect blood sugar levels?

A: XEMNOL SR 500 TABLET may improve HbA1c levels in diabetic patients, indicating a potential benefit in blood sugar control. However, it should be used cautiously, and blood sugar levels should be monitored regularly

Q: Is XEMNOL SR 500 TABLET safe for people with diabetes or high blood pressure?

A: XEMNOL SR 500 TABLET can be used in patients with diabetes and high blood pressure. However, dose adjustments may be necessary, and regular monitoring is recommended, especially for kidney function and blood sugar levels.

Q: Can XEMNOL SR 500 TABLET be used in patients with kidney or liver issues?

A: XEMNOL SR 500 TABLET should be used with caution in patients with kidney or liver impairment. Dose adjustments may be required, and regular monitoring of kidney and liver function is advised. It is contraindicated in patients with severe liver disease.

Q: Can XEMNOL SR 500 TABLET be taken with other heart medications?

A: XEMNOL SR 500 TABLET can be taken with other heart medications, but caution is needed when combining it with certain drugs, such as: CYP3A inhibitors (e.g., ketoconazole, clarithromycin) QT-prolonging agents

These combinations may increase the risk of side effects. Always consult your doctor before starting any new medications.

Q: Can I take XEMNOL SR 500 TABLET if I already take a statin?

A: Combining XEMNOL SR 500 TABLET with statins like simvastatin is generally not recommended due to the risk of simvastatin toxicity, which can lead to muscle weakness and other serious side effects. If co-administration is necessary, your doctor will carefully monitor for adverse effects

References

1. Ranolazine Prescribing Information USFDA. Revised on January 2016. [Accessed on 21st June 2025].
2. Ranolazine Statpearls Revised on 28th February 2016. [Accessed on 21st June 2025].

Useful Diagnostic Tests

• Cardiac Risk Markers - Advanced
• Comprehensive Cardiac Risk Screening with 12 Lead ECG and BP

Author Details

Written By Dr. Karthikeyan Rajagopal - M.Pharm (Pharmacology)

Reviewed By Dr. Sankara Babu Gorle - MBBS, MD(Pharmacology) View profile

Last updated on 21 Jun 2025 | 05:10 PM(IST)