Ranexa Resistance

[franners]

I have been on Ranexa for 4 months,and have had great results until the last week. Before I was taking the drug I was taking 3-4 ntg a day, and did get relief. I have small vessel disease,plus a 50% occlusion of my LAD after being restented  2years ago. Recently I had a near syncopal episode while driveing and my doctor thought it was due to orthostatic hypotentsion, he cut my Imdur down to 60mg daily. After about 5 days on the lower dose I started haveing pain again,not as severe,but I upped my Indur back to 90mg which has helped. But I am having some episodes of angina even after 2 weeks on my initial dose. I am on 500mg bid of Ranexa-Have other pts had recurrent pain after a couple of months on Ranexa which required higher doseing ? I am also concerned because the literature states caution should be used when using Ranexa if you are less than 60 kgs, which I am, and also have had non sustained v-tach a couple of times.
Thank-you

[elagnaf]

i think u need to have a repeat angiogram to mak sure that u dont have what so called instent restenosis.

in my experience I tink the must likey wit is either the stent bocked or u got other vessles blocked and both cases u need to increase ur medication and  repeat angiogram
i dont advicedoing excercise stress test as it will be postive ayway.

regards
r el-agnaf

[franners]

it is interesting you commented about the fainting, my doctor thought it ws a hypotnesive  episode while i was driveing, but i have the feeling now it was a bradycardia.  I have an enlarged left ventricle and have had chf, I know I feel my heart race at times and is slow alot. I am a working RN in an emergency room and I too worry if people know the troubles I am having I would not have a job, I am 58 years old and need to work another 4-5 years at least. I would not be opposed to a pacer if it would help. Yesterday while learning to drive a dixie chopper to mow the grass i became really scared when I lost control of the mower and had a pretty intense episode chest pain.I see my cardiologist this week, so we will see,
Thanks

[Flycaster305]

I have a history very similar to yours: angina after eight stents, a 60% block the the LAD, small vessel disease.  My left atrium and left ventricle are enlarged, I also had a couple of heart attacks.  I also was taking Imdur, 90 mg and 500 mg Ranexa twice a day.  However, I developed Brady-Tachy syndrome, both from the drugs and the dilated left atruim, and fainted a number of times.  I didn't tell anyone, I was afraid of losing my driver's license (I know, that's irresponsible) but my wife discovered my secret, ratted me out and I ended up with a pacemaker.  I'm now still taking Imdur 90mg,  1000mg Ranexa 2 times a day.  Also, my Coreg was bumped up to 50 mg a day, and the angina hits are rare.  
You might ask your doctor if a pacemaker would be in your best interests.
Best wishes.