If you searched for the price of Ranexa, the first thing worth knowing is that you cannot buy it. The FDA’s Drugs@FDA database lists both strengths of the brand, NDA 021526, as Discontinued as of September 2026, with the standard Federal Register note that the withdrawal was not for safety or effectiveness reasons. What is on pharmacy shelves is generic ranolazine extended-release, and about eighteen separate generic applications are still in active Prescription status.
That matters for your budget because the brand-to-generic collapse here was steep and is still going. This guide prices a real month of therapy rather than a per-tablet figure, because ranolazine is dosed twice daily and a genuine 30-day supply is 60 tablets, not 30. Every number below was researched on September 4, 2026.
What Does Ranexa Cost Without Insurance?
Acquisition costs come from the CMS National Average Drug Acquisition Cost survey, effective August 19, 2026. Card and retail prices come from SingleCare’s ranolazine ER page, which states its prices were updated September 4, 2026, and from Cost Plus Drugs, read the same day. Plan-payment figures are from the CMS Medicare Part D Spending by Drug dataset. Office visit figures are 2024 national averages from the CMS Medicare Physician and Other Practitioners by Geography and Service file.
| Item | Low | Typical | High |
|---|---|---|---|
| Ranolazine ER 500 mg, 30 tablets | $4.83 (CMS acquisition cost) | $8.42 (Cost Plus Drugs) | $162.00 (retail Cost Plus quotes for other pharmacies) |
| Ranolazine ER 1,000 mg, 30 tablets | $8.36 (CMS acquisition cost) | $10.66 (Cost Plus Drugs) | $201.60 (retail Cost Plus quotes for other pharmacies) |
| One month at 500 mg twice daily (60 tablets) | $9.65 (CMS acquisition cost) | $26.73 (SingleCare card price) | $383.33 (SingleCare undiscounted retail) |
| One year at 500 mg twice daily | $117 | $321 | $4,600 |
| Average Medicare Part D payment per fill | $89.24 (2024) | $137.41 (2023) | $179.85 (2020) |
| Brand Ranexa, 500 mg or 1 gm | Discontinued | Discontinued | Discontinued |
| Cardiology follow-up visit (CPT 99214) | $90.37 (allowed, facility) | $119.71 (allowed, office) | $276.45 (average billed charge) |
The spread on that third row is the whole story of this page. The same 60 tablets are $9.65 of drug at wholesale, $26.73 with a free discount card, and $383.33 if you walk in and pay the sticker price. That is a 40-fold gap between the cheapest and most expensive way to buy an identical generic in the same month.
Cost Plus Drugs publishes its arithmetic, which makes a 60 tablet month easy to reason about. Its $8.42 price for 30 of the 500 mg tablets breaks down as $2.97 of manufacturing cost, a $0.45 markup and a flat $5.00 pharmacy labor fee, with $5.25 of standard shipping added at checkout. Because the labor fee is flat, doubling the tablet count roughly doubles only the first two lines, so a 60 tablet fill lands near $12 plus shipping.
What Drives the Price
There is no brand premium left, only a retail one. With Ranexa discontinued, the entire price range you see is generic ranolazine sold at wildly different markups. SingleCare’s per-pharmacy table on September 4, 2026 showed monthly retail prices for the same 60 tablets running from $70.80 to $404.40 across five chains. Those named-chain rows move day to day and are worth treating as an illustration of spread rather than a quote, but the spread itself is real and stable.
The dose you land on doubles or halves the bill. The label starts patients at 500 mg twice daily and allows an increase to 1,000 mg twice daily based on symptoms. At acquisition cost that is the difference between $9.65 and $16.72 a month, and at retail it is a much bigger swing, since Cost Plus quotes $162.00 versus $201.60 as the outside retail price for 30 of each strength.
Tablet count, not day count, is what pharmacies price. Ranolazine is twice daily, so a 30-day supply is 60 tablets. Discount-card sites and pharmacy quotes frequently default to a 30 count, which looks half as expensive as your actual month. Always confirm the quantity attached to a quoted price before you compare two pharmacies.
Generic entry is still pushing the price down. CMS Part D data shows the average payment per dosage unit falling from $1.7477 in 2020 to $0.7844 in 2024, and the average payment per fill from $179.85 to $89.24 across the same period. Prices this fast-moving mean a quote from a year-old article is not a useful benchmark.
The drug is rarely the biggest line in an angina budget. At CMS acquisition prices effective August 19, 2026, a full common regimen of ranolazine ER 500 mg twice daily, metoprolol succinate ER 50 mg, atorvastatin 40 mg, isosorbide mononitrate ER 30 mg and a bottle of 25 sublingual nitroglycerin tablets comes to about $16.60 of wholesale drug for 30 days. That is less than five percent of a single undiscounted retail ranolazine fill. Our guides to metoprolol costs and atorvastatin costs price those pieces individually.
Cash Price vs. Insurance
For ranolazine specifically, paying cash usually wins. A $12 Cost Plus fill or a $26.73 card price is below most commercial copays and well below what a Part D plan paid per fill on average in 2024. If your plan has a deductible you have not met, running the claim is almost certainly the more expensive choice.
The reason the cash route works here is that ranolazine is now a commodity generic with many manufacturers. That is not true of everything on a cardiac shelf. If you are also on an anticoagulant or a newer antiplatelet, check those separately, because our Brilinta cost guide and Plavix cost guide show a very different pattern.
Where insurance still earns its keep is the office side. A cardiology follow-up billed as CPT 99214 carried a 2024 average submitted charge of $276.45 in an office setting against a Medicare-allowed amount of $119.71, a gap you cannot close by asking politely at the front desk. If you have any coverage at all, use it for the visits even when you pay cash for the pills.
One thing this page does not do is tell you whether to take ranolazine, change your dose, or stop it. Those are questions for the prescriber. This is a pricing guide.
How to Pay Less
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Ask for the price on 60 tablets, not 30. This single question fixes more comparison errors than anything else on this list. A pharmacy quoting $8.42 for a 30 count and one quoting $26.73 for a 60 count are not what they appear to be at first glance.
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Run a discount card before you fill. SingleCare’s published card price of $26.73 for 60 of the 500 mg tablets on September 4, 2026 sits against its own stated undiscounted price of $383.33 for the same fill. Cards are free and take a minute. Our comparison of GoodRx vs. SingleCare covers how to check more than one on the same prescription, since the winner changes by drug and by pharmacy.
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Price a transparent mail pharmacy against the card. Cost Plus Drugs publishes $8.42 for 30 of the 500 mg tablets and $10.66 for 30 of the 1,000 mg, plus $5.25 standard shipping, with the pricing formula shown on the page. For a twice-daily drug you will usually be filling 60 or 180 tablets at a time, which spreads that flat $5.00 labor fee and the shipping across more doses.
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Fill 90 days at a time. The flat fees in every one of these pricing models are per fill, not per tablet. Three months in one transaction pays one labor fee and one shipping charge instead of three, which is the cheapest structural change available on a stable chronic prescription.
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Get the whole regimen from the same cheap source. If the statin, the beta blocker and the nitrate are also generics, filling them together at a transparent pharmacy or on the same card usually beats splitting them across chains. Use our fair price checker to sanity-check whatever you are quoted before you hand over a card.
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Handle the visit costs separately from the drug costs. The follow-up appointments, not the pills, are what makes chronic angina expensive without insurance. A free or sliding-scale clinic can often handle the refill and the routine check on an income-based fee, and if a bill has already arrived, our guide to negotiating medical bills has the scripts for the gap between the $276.45 charge and the $119.71 rate.
Bottom Line
Ranexa as a product no longer exists, and generic ranolazine ER is now a $12 to $27 a month drug for anyone who shops it, or a $383 a month drug for anyone who does not. The difference is a free card or a transparent mail pharmacy, not eligibility for anything.
The number to actually plan around is the regimen and the follow-up, not the tablet. Budget $117 to $321 a year for the drug, add the other cardiac generics (which run a few dollars a month each at wholesale), and treat the cardiology visits as the real recurring expense. If an antiarrhythmic gets added to the mix later, our amiodarone cost guide shows how quickly required monitoring can outrun the price of the pills themselves.