Medications Used to Treat Coronary Artery Disease*
Examples | Some Side Effects | Comments |
|---|---|---|
Angiotensin-converting enzyme (ACE) inhibitors | ||
BenazeprilBenazepril CaptoprilCaptopril EnalaprilEnalapril FosinoprilFosinopril LisinoprilLisinopril MoexiprilMoexipril PerindoprilPerindopril QuinaprilQuinapril RamiprilRamipril TrandolaprilTrandolapril | Cough, usually dry and metallic Rash Rarely, a severe allergic reaction (angioedema) Possibly worsening of kidney function when people already have kidney disease or when the artery to one of the kidneys is greatly narrowed | These medications lower blood pressure and treat heart failure and prevent kidney damage in people with high blood pressure or diabetes. They also benefit people who have had heart attacks. People who have high blood pressure, heart failure, or prior heart attacks and who are treated with an ACE inhibitor live longer than people who do not take an ACE inhibitor. |
Angiotensin II receptor blockers (ARBs) | ||
CandesartanCandesartan Eprosartan IrbesartanIrbesartan LosartanLosartan OlmesartanOlmesartan TelmisartanTelmisartan ValsartanValsartan | Similar to ACE inhibitors, but cough is much less common | These medications have equivalent effects and benefits to those of ACE inhibitors. In people with severe high blood pressure or heart failure, these medications may be used in combination with an ACE inhibitor. |
Other medications | ||
RanolazineRanolazine | Dizziness, headache, constipation, and nausea | This medication is used to treat people who continue to have symptoms of angina despite treatment with other drugs. |
IvabradineIvabradine | Blurred vision, chest discomfort, slow or fast heartbeat,headache, dizziness or fainting | This medication is used to treat symptoms of angina in some people who cannot take beta-blockers. |
Anticoagulants | ||
ArgatrobanArgatroban ApixabanApixaban BivalirudinBivalirudin DabigatranDabigatran DalteparinDalteparin EnoxaparinEnoxaparin FondaparinuxFondaparinux HeparinHeparin RivaroxabanRivaroxaban Tinzaparin WarfarinWarfarin | Bleeding, especially when used with other medications that have a similar effect (such as aspirin and other nonsteroidal anti-inflammatory drugs) | These medications prevent blood from clotting. They are used to treat people who have unstable angina or who have had a heart attack. |
Antiplatelet medications | ||
AspirinAspirin ClopidogrelClopidogrel PrasugrelPrasugrel TicagrelorTicagrelor TiclopidineTiclopidine | Bleeding, especially when used with other medications that have a similar effect (such as anticoagulants) With aspirin, stomach irritation With ticlopidine and less so with clopidogrel, a small risk of reducing the white blood cell count | These medications prevent platelets from clumping and blood clots from forming. They also reduce the risk of a heart attack. They are used to treat people who have stable or unstable angina or who have had a heart attack. Aspirin is taken as soon as a heart attack is suspected. People with an allergy to aspirin may take clopidogrel or ticlopidine as an alternative. |
Beta-blockers | ||
AtenololAtenolol BisoprololBisoprolol CarvedilolCarvedilol MetoprololMetoprolol | Spasm of airways (bronchospasm) Abnormally slow heart rate (bradycardia) Heart failure Cold hands and feet Insomnia Fatigue Shortness of breath Depression Raynaud syndrome Vivid dreams Hallucinations Sexual dysfunction With many beta-blockers, an increase in the triglyceride level and a decrease in the level of high density lipoprotein (HDL), which is the "good" cholesterol | These medications reduce the workload of the heart and the risk of a heart attack and sudden death. They are used to treat people who have stable or unstable angina or microvascular angina or who have had a heart attack. |
Calcium channel blockers | ||
AmlodipineAmlodipine DiltiazemDiltiazem FelodipineFelodipine Nifedipine (sustained-release only)Nifedipine (sustained-release only) VerapamilVerapamil | Dizziness Fluid accumulation (edema) in the ankles Flushing Headache Heartburn Enlarged gums Abnormal heart rhythms (arrhythmias) With verapamil, constipationWith verapamil, constipation With short-acting, but not long-acting, calcium channel blockers, possible increased risk of death due to heart attack, especially in people who have unstable angina or who have had a heart attack recently | These medications prevent blood vessels from narrowing and can reverse artery spasm. Diltiazem and verapamil reduce the heart rate. Calcium channel blockers are used to treat people who have stable angina.These medications prevent blood vessels from narrowing and can reverse artery spasm. Diltiazem and verapamil reduce the heart rate. Calcium channel blockers are used to treat people who have stable angina. |
Glycoprotein IIb/IIIa inhibitors (a type of antiplatelet medication) | ||
AbciximabAbciximab EptifibatideEptifibatide TirofibanTirofiban | Bleeding, especially when used with other medications that have a similar effect (such as anticoagulants or thrombolytic medications) Reduction of the platelet count | These medications prevent platelets from clumping and blood clots from forming. They may be used to treat people who have unstable angina, particularly those who are undergoing percutaneous coronary intervention after a heart attack. |
Nitrates | ||
Isosorbide dinitrateIsosorbide dinitrate Isosorbide mononitrateIsosorbide mononitrate NitroglycerinNitroglycerin | Flushing Headache Temporarily fast heart rate (tachycardia) | These medications relieve angina, prevent episodes of angina, and reduce the risk of a heart attack and sudden death. (However, risk reduction is much less than that with beta-blockers.) They are used to treat people who have stable or unstable angina or microvascular angina. For these medications to remain effective over the long term, people need to go 8 to 12 hours without taking the medication each day. |
Opioids | ||
MorphineMorphine | Low blood pressure when a person stands Constipation Nausea Vomiting Confusion (especially in older adults) | In some people who have had a heart attack, these medications are used to relieve anxiety and pain if the pain persists despite use of other medications. |
PCSK-9 inhibitors | ||
AlirocumabAlirocumab EvolocumabEvolocumab | Few serious side effects | These medications are used to lower LDL-C, which is the "bad" cholesterol, in patients not at target LDL-C levels. They are used alone or in combination with other lipid-lowering medications (eg, statins, ezetimibe) for the treatment of adults with primary These medications are used to lower LDL-C, which is the "bad" cholesterol, in patients not at target LDL-C levels. They are used alone or in combination with other lipid-lowering medications (eg, statins, ezetimibe) for the treatment of adults with primaryhyperlipidemia (including familial hypercholesterolemia), including people who have trouble tolerating other medications that lower cholesterol |
Statins† | ||
AtorvastatinAtorvastatin FluvastatinFluvastatin LovastatinLovastatin PravastatinPravastatin RosuvastatinRosuvastatin SimvastatinSimvastatin | Occasionally, muscle aches and pains, but rarely severe muscle pain (myositis) Rarely, liver damage, but not more commonly than in people who are not taking the medication | These medications lower cholesterol levels and help to heal damaged arteries, decreasing the chance of having a first or repeated heart attack or stroke. |
Thrombolytic drugs | ||
AlteplaseAlteplase Anistreplase Reteplase Streptokinase TenecteplaseTenecteplase | Rarely, bleeding within the brain (intracerebral hemorrhage) or the digestive tract | These medications dissolve blood clots. They are used to treat people who have had a heart attack. |
* Doctors may use different combinations of medications depending on the type of coronary artery disease the person has. | ||
† Also known as hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors. | ||