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Related Experiment Video

Updated: May 20, 2026

Bladder Smooth Muscle Strip Contractility as a Method to Evaluate Lower Urinary Tract Pharmacology

Bladder Smooth Muscle Strip Contractility as a Method to Evaluate Lower Urinary Tract Pharmacology

Published on: August 18, 2014

Ranolazine-induced severe bladder hypotonia.

Marco Panfili¹, Massimo Iafrate, Filippo Marzot

¹Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.

The Annals of Pharmacotherapy

|July 26, 2012

Summary

This summary is machine-generated.

Ranolazine treatment may cause acute urinary retention in elderly men due to bladder hypotonia. Stopping the medication resolved the issue, suggesting a probable causal link.

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Area of Science:

Cardiology
Pharmacology
Urology

Background:

An 81-year-old male with cardiovascular disease was treated with ranolazine for angina and heart failure.
The patient's ranolazine dosage was increased after initial treatment.

Observation:

The patient developed acute urinary retention (AUR) shortly after the ranolazine dose increase.
Urodynamic studies indicated severe detrusor muscle hypocontractility as the cause of AUR.
Standard treatments for AUR were ineffective.

Findings:

Discontinuation of ranolazine led to spontaneous voiding within 48 hours.
A second urodynamic study confirmed significant improvement in detrusor contractility.
The Naranjo criteria suggested a probable causal relationship between ranolazine and bladder hypotonia.

Implications:

Ranolazine-induced bladder hypotonia is a potential cause of AUR in elderly men.
The mechanism may involve blockage of the late sodium current in smooth muscle cells.
Reduced CYP3A4 activity, possibly exacerbated by diltiazem, may lead to elevated ranolazine levels and increased risk.