This analysis examined the safety and efficacy of extended-release ranolazine among patients aged 70 years or older (n=363) compared with patients younger than 70 years (n=1024) enrolled in 2 large multinational prospective clinical trials. The primary end points were exercise capacity and number of weekly angina episodes. Beneficial effects of ranolazine, relative to placebo, were generally similar for each of these outcomes among older and younger participants. For example, at a ranolazine dose of 1000 mg bid, mean exercise duration increased by 19.8±13.1 seconds (mean ± SE) relative to placebo in patients younger than 70 years and by 32.4±19.7 seconds relative to placebo in patients 70 years or older. Adverse effects were more common in older than in younger patients, but the incidence of serious adverse effects attributable to ranolazine did not differ significantly between age groups. Outcomes were also similar at dosages of either 750 mg or 1000 mg bid. In conclusion, pooled data from 2 large randomized trials indicate that the efficacy of ranolazine is similar in older and younger patients but that adverse effects are more common in the elderly.