Ranolazine toxicity precipitating seizure in the elderly

Area of Science:

• Pharmacology
• Neurology
• Nephrology

Background:

• Ranolazine is a medication used for chronic angina.
• Elderly patients and those with renal impairment may be at higher risk for adverse drug events.
• New-onset epilepsy can be a rare side effect of certain medications.

Purpose of the Study:

• To report a case of ranolazine toxicity presenting as new-onset epilepsy.
• To highlight the potential risk of ranolazine in elderly patients with chronic kidney disease.

Main Methods:

• A case report of an elderly female patient with stage III chronic kidney disease.
• Review of patient's medication history, laboratory results, and diagnostic tests including electroencephalogram.
• Discontinuation of ranolazine and observation of patient's clinical response.

Main Results:

• The patient experienced episodes of stiffening, shaking, and confusion, diagnosed as seizure activity.
• Laboratory workup revealed elevated creatinine, indicating worsening renal function.
• Discontinuation of ranolazine resulted in the patient's return to her mental baseline.

Conclusions:

• Ranolazine toxicity can manifest as new-onset epilepsy.
• Elderly patients and individuals with renal dysfunction are more susceptible to ranolazine-induced epilepsy.
• Careful monitoring and consideration of medication alternatives are recommended in at-risk populations.