Drug Interaction Report

Aripiprazole Injection and Ranolazine: Interaction Details

Name: Aripiprazole Injection and Ranolazine Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Aripiprazole Injection and Ranolazine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

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

Ranolazine

Aspruzyo Ranexa

Aripiprazole Injection

Abilify Abilify Maintena® Abilify® Aristad Initio® Aristada® Opipza

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Jul 11, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

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 347 documented Aripiprazole Injection interactions, 316 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.

Onset

unspecified

Evidence

theoretical

Severity

Major

What happens

Increased ARIPiprazole or ARIPiprazole lauroxil (a prodrug of ARIPiprazole) exposure and an increased risk of QT interval prolongation

Interaction Deep Dive

Coadministration of ranolazine and CYP2D6 substrates, such as ARIPiprazole or ARIPiprazole lauroxil (a prodrug of ARIPiprazole) may increase ARIPiprazole or ARIPiprazole lauroxil exposure. Hence, lower doses of ARIPiprazole or ARIPiprazole lauroxil may be required⁶. Additionally, concomitant use of ARIPiprazole or ARIPiprazole lauroxil and other QT prolonging agents, such as ranolazine may cause QTc interval prolongation ²³¹⁴⁵.

Why it happens (mechanism)

Inhibition of CYP2D6-mediated metabolism of ARIPiprazole or ARIPiprazole lauroxil (a prodrug of ARIPiprazole); additive QT interval prolongation

Literature reports

1 report — tap to read

a) In a drug interaction study, coadministration of ranolazine 750 mg twice daily with a single dose of immediate release metoprolol (100 mg), a CYP2D6 substrate resulted in increased metoprolol exposure by 80% in extensive CYP2D6 metabolizers with no need for dose adjustment of metoprolol. In extensive metabolizers of dextromethorphan, a substrate of CYP2D6, ranolazine inhibits partially the formation of the main metabolite dextrorphan ⁶.

Common questions

Can I take Aripiprazole Injection and Ranolazine together?

Increased ARIPiprazole or ARIPiprazole lauroxil (a prodrug of ARIPiprazole) exposure and an increased risk of QT interval prolongation Always confirm with your pharmacist or prescriber before making any change.

How serious is the Aripiprazole Injection 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 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 Aripiprazole Injection 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 (6)

Product Information: ABILIFY ASIMTUFII(R) intramuscular extended-release suspension, aripiprazole intramuscular extended-release suspension. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2023.
Product Information: ABILIFY(R) oral tablets, oral solution, intramuscular injection, aripiprazole oral tablets, oral solution, intramuscular injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2022. DailyMed
Product Information: ABILIFY MAINTENA(R) intramuscular extended-release injection, aripiprazole intramuscular extended-release injection. Otsuka America Pharmaceutical Inc (per FDA), Rockville, MD, 2020.
Product Information: ARISTADA(R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes Inc (per FDA), Waltham, MA, 2018.
Product Information: ARISTADA INITIO (R) intramuscular extended-release injection, aripiprazole lauroxil intramuscular extended-release injection. Alkermes, Inc (per manufacturer), Waltham, MA, 2020.
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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Ranolazine

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All Ranolazine interactions (149)

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Aripiprazole Injection

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Also serious with: Mavorixafor Mesoridazine Metoclopramide Pimozide

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:

Ranolazine + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Sida Cordifolia St. John's Wort + 145 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

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.