Drug Interaction Report

Abrocitinib and Ranolazine: Interaction Details

AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Ranolazine

Aspruzyo Ranexa
+

Abrocitinib

Cibinqo Cibinqo®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 10, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 67 documented Abrocitinib interactions, 46 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
At a glance + Theoretical Effects may be stronger
The Bottom Line
Abrocitinib can raise ranolazine levels by blocking a drug-clearing pump, so your ranolazine dose may be adjusted and you may be watched more closely for side effects. Keep taking both as prescribed and report any new symptoms.

Let's talk about taking ranolazine (Ranexa) together with abrocitinib (Cibinqo). Abrocitinib can slow down a natural "pump" in your body that helps clear ranolazine out. When that pump is blocked, more ranolazine can build up in your blood. That could make ranolazine side effects more likely, like dizziness, headache, nausea, or feeling lightheaded.

Here's the reassuring part: this is based mostly on how these drugs are expected to behave, not on lots of real-world reports. Your care team can manage it easily by adjusting your ranolazine dose based on how you feel and watching you a bit more closely. Keep taking both as prescribed, and let your pharmacist or doctor know if you notice new symptoms.

Effect: Abrocitinib may increase ranolazine exposure via inhibition of P-gp-mediated efflux of ranolazine, raising AUC/Cmax and the risk of ranolazine-related adverse effects (dizziness, nausea, QT prolongation risk).

  • Direction: Increased ranolazine effect (neither drug is a prodrug here).
  • Magnitude: Not quantified.
  • Onset: Unspecified.
  • Evidence: Theoretical; rated major.
  • Management: Titrate ranolazine to clinical response with concomitant predominant P-gp inhibitors; monitor for adverse effects and consider ECG/QTc surveillance per clinical judgment.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased ranolazine exposure and an increased risk of ranolazine-related adverse effects

Interaction Deep Dive

Taking ranolazine together with P-gp inhibitors can raise ranolazine levels in the body. For patients receiving concurrent therapy with predominant P-gp inhibitors, adjust the ranolazine dose according to the clinical response1.

Why it happens (mechanism)

Inhibition of P-gp-mediated efflux transport of ranolazine

How to manage this interaction

Good news: this is manageable with your care team's help.

  • Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
  • Your ranolazine dose may need to be adjusted and individualized based on how you respond, since abrocitinib can raise ranolazine levels.
  • Your team may monitor you more closely for side effects like dizziness, nausea, lightheadedness, or palpitations.
  • Tell your pharmacist or doctor promptly if you notice any new or worsening symptoms after starting both medicines.

Management is individual — confirm any change with your pharmacist or prescriber.

Common questions

Can I take Abrocitinib and Ranolazine together?

Abrocitinib can raise ranolazine levels by blocking a drug-clearing pump, so your ranolazine dose may be adjusted and you may be watched more closely for side effects. Keep taking both as prescribed and report any new symptoms. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Abrocitinib and Ranolazine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How is the Abrocitinib and Ranolazine interaction managed?

Good news: this is manageable with your care team's help. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Your ranolazine dose may need to be adjusted and individualized based on how you respond, since abrocitinib can raise ranolazine levels. Your team may monitor you more closely for side effects like dizziness, nausea, lightheadedness, or palpitations. Tell you… Management is individual — always follow your own care team's guidance.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Abrocitinib or Ranolazine need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: RANOLAZINE oral extended-release tablets, ranolazine oral extended-release tablets. Viona Pharmaceuticals Inc. (per Dailymed), Cranford, NJ, 2023. DailyMed
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.