A Study of Ranolazine in ALS

Inclusion Criteria:

• 18 years or older

• Diagnosed with clinically definite, possible, probably, or lab-supported probableALS per revised El Escorial criteria

• Breathing assessment called forced vital capacity (FVC) greater than or equal to 50%.

• Able to swallow pills at the start of the study and expected to for the length ofthe study.

• If on ALS modifying medications must be on a stable dose at least 30 days.

• Experiencing 4 or more cramps per week during a 2-week screening period.

Exclusion Criteria:

• Disease duration < 5 years

• Tracheostomy invasive ventilation, or noninvasive ventilation of more than 12hours/day

• Pregnant or lactating, adults unable to consent, and prisoners

• Taking ranolazine or investigational drug or has received an investigational drugwithin 30 days (or 5 half-lives for drugs, whichever is longer) prior to screening

• Medically uncontrolled comorbidities (heart, liver, kidney disease)

• Baseline QTc interval prolongation >450 ms for men/ >470 ms for women, history oflong QT syndrome, or medications which prolong the QT interval

• Participation in an experimental drug trial less than 30 days before screening

• Patients have to be on a stable dosage of any medications used to treat musclecramps for ≥30 days or have been off these medications ≥30 days prior torandomization.