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Laboratory work up revealed an elevated creatinine of 2.42 compared with baseline of 1.9. Imaging studies revealed no acute findings suggestive of stroke. Electroencephalogram demonstrated seizure activity, and lacosamide 100\u2009mg two times per day was prescribed. During her hospital stay, ranolazine was discontinued and the patient gradually returned to her mental baseline. This case demonstrates ranolazine toxicity that manifests as new-onset epilepsy which is more likely to occur in the elderly and patients with renal dysfunction.<\/jats:p>","DOI":"10.1136\/bcr-2024-260134","type":"journal-article","created":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T09:25:25Z","timestamp":1734859525000},"page":"e260134","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Ranolazine toxicity precipitating seizure in the elderly"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-0216","authenticated-orcid":false,"given":"Evan Paul","family":"Tracy","sequence":"first","affiliation":[{"name":"Medicine, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred","family":"Furtado","sequence":"additional","affiliation":[{"name":"Medicine, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Stanton","sequence":"additional","affiliation":[{"name":"Medicine, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Kingery","sequence":"additional","affiliation":[{"name":"Medicine, University of Louisville, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"2025082701283056000_17.12.e260134.1","first-page":"9","article-title":"Prevalence of Refractory Angina in Clinical Practice","volume":"72","author":"Gowdak","year":"2017","journal-title":"Heart Metab"},{"key":"2025082701283056000_17.12.e260134.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2013.200"},{"key":"2025082701283056000_17.12.e260134.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.1.62"},{"key":"2025082701283056000_17.12.e260134.4","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2"},{"key":"2025082701283056000_17.12.e260134.5","first-page":"1065","article-title":"Sex Differences in the Biology and Pathology of the Aging Heart","volume":"32","author":"Keller","year":"2016","journal-title":"Can J Cardiol"},{"key":"2025082701283056000_17.12.e260134.6","doi-asserted-by":"publisher","DOI":"10.1152\/AJPCELL.00021.2020"},{"key":"2025082701283056000_17.12.e260134.7","doi-asserted-by":"crossref","unstructured":"Tracy EP , Hughes W , Beare J , et al . 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