Ranolazine and nelfinavir
Desk tier: Avoid together
Mechanism: strong CYP3A4 inhibition of clearance (↑ exposure)
“Ranolazine is contraindicated in patients: Taking strong inhibitors of CYP3A … Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin, nelfinavir)”
Why this grade
Ranolazine extended-release label, Contraindications
The Ranolazine extended-release label lists this combination under Contraindications. 4 CONTRAINDICATIONS: "Ranolazine is contraindicated in patients: Taking strong inhibitors of CYP3A … Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin, nelfinavir)" Named in the label: "nelfinavir" Retrieved from DailyMed 2026-10-12.
Ranolazine extended-release label on DailyMedFDA interaction table
FDA's example-interaction table lists nelfinavir as a strong CYP3A inhibitor. FDA grades the roles; the severity tier on this row is the desk's rule. Table content current as of 2026-05-29.
FDA interaction tableAll pairs for Ranolazine · nelfinavir
Enzyme behind this pair: CYP3A4
Educational reference only. Not FDA-cleared. The Prescribing Information governs.
Drug and product names are trademarks of their owners and are used only to identify the products.