Which antianginal agent necessitates monitoring of renal function?

Ranolazine is an antianginal agent that requires monitoring of renal function because it is primarily metabolized by the liver, but its elimination is also significantly affected by renal function. In patients with renal impairment, the clearance of ranolazine can be reduced, leading to increased drug exposure and potential toxicity. Therefore, it is crucial to check kidney function before and during treatment with ranolazine to adjust dosing appropriately and minimize the risk of adverse effects.

In contrast, while glyceryl trinitrate, amiodarone, and atenolol may have some considerations regarding renal function, they do not necessitate the same level of careful monitoring as ranolazine. Glyceryl trinitrate's main concern revolves around tolerance and hemodynamic effects rather than renal impact. Amiodarone, though it can affect various organ systems, does not require routine renal function monitoring in the same way as ranolazine. Atenolol, a beta-blocker, does have some dosing considerations in renal impairment, but it is more focused on cardiovascular effects rather than strict renal monitoring.