Vasodilators

• Nitroglycerin

Vasodilators help dilate or widen blood vessels. People with CAD have blood vessels that are narrowed, which reduces the amount of blood that can be delivered to the heart muscle. Nitrates or nitroglycerin may be used to immediately relieve an attack of angina that is occurring, or prevent or reduce future attacks. Nitrates come in many preparations, including tablets, sprays for use under the tongue, ointments, or patches for placement on the skin. The tablets or sprays are used at times of anginal episodes, while the ointment or patch is used on a daily basis for prevention of attacks.

Possible side effects include:

• Headache
• Lightheadedness or faintness from low blood pressure
• Rapid heart rate— tachycardia
• Flushing of face and neck
• Nausea or vomiting
• Restlessness

Beta-Blockers

• Metoprolol
• Atenolol
• Nadolol
• Propranolol
• Carvedilol
• Bisoprolol
• Pindolol Timolol
• Acebutolol
• Labetalol
• Betaxolol
• Carteolol
• Penbutolol
• Esmolol

These medications help slow the heart rate and reduce blood pressure, especially during exercise. They are intended to prevent anginal attacks or heart attacks. Beta-blockers are also prescribed when recovering from a heart attack in order to lessen the likelihood of recurrence.

Possible side effects include:

• Decreased sexual ability
• Lightheadedness or faintness from low blood pressure
• Trouble sleeping/nightmares
• Unusual tiredness or weakness
• Breathing difficulty or asthma

Statins

• Atorvastatin
• Pravastatin
• Lovastatin
• Simvastatin
• Fluvastatin
• Rosuvastatin

Statins are drugs that help to lower cholesterol levels and decrease inflammation. They are often prescribed to people diagnosed with CAD. These medications may reduce the risk of stroke and heart attack.

Possible side effects include:

• Headache
• Stomach ache
• Diarrhea
• Muscle weakness
• Rarely, liver damage

Calcium Channel Blockers

• Nifedipine
• Verapamil
• Diltiazem
• Amlodipine
• Felodipine
• Isradipine
• Nisoldipine

These medications affect the movement of calcium into the cells of the heart and blood vessels. As a result, blood vessels dilate. The supply of blood and oxygen to the heart is increased, while the heart's workload is decreased. This helps to prevent anginal attacks, as well as lessen the possibility of heart attacks.

Possible side effects include:

• Constipation
• Swollen legs
• Unusual tiredness or weakness
• Headache
• Palpitations

Antiplatelet Agents

• Aspirin
• Clopidogrel
• Ticlopidine
• Dipyridamole

Antiplatelet agents prevent the formation of blood clots by keeping platelets from clumping and sticking together.

Possible side effects include:

• Nausea and vomiting
• Diarrhea
• Skin rash
• Ringing in the ears— tinnitus
• Skin bruising
• Irritation of the stomach lining
• Bleeding from the digestive system and other internal organs
• Allergic reaction

Anticoagulants

• Warfarin

Anticoagulants are given to “thin” the blood, in an effort to prevent the formation of blood clots. The most serious side effect is bleeding.

Possible side effects include:

• Bloody or tarry black stools
• Nosebleeds
• Heavy menstrual periods
• Easy bruising
• Allergic reaction

Nicorandil

This medication, which contains a nitrate, dilates blood vessels by affecting the potassium flow in the heart cells and blood vessels.

Ranolazine

Ranolazine is an anti-anginal medication that does not depend on reductions in heart rate or blood pressure. It reduces the frequency of anginal chest pain, but has not been shown to reduce heart attacks.

Possible side effects include:

• Lightheadedness
• Headache
• Nausea
• Constipation
• Potential to interact with other medication—This medication should be avoided in people with liver or severe kidney disease.

Angiotensin-converting Enzyme (ACE Inhibitors)

• Benazepril
• Captopril
• Enalapril
• Fosinopril
• Lisinopril
• Moexipril
• Perindopril
• Quinapril
• Ramipril

ACE inhibitors work to dilate blood vessels by interfering with the action of angiotensin, a chemical that contracts and narrows blood vessels.

Possible side effects include:

• Cough
• Headache
• Lightheadedness
• Increased levels of potassium in the blood

Aspirin

A small, daily dose of aspirin has been shown to decrease the risk of heart attack by preventing blood clots from forming. Ask your doctor before taking aspirin daily. A possible side effect of taking aspirin regularly is bleeding in the stomach and gastrointestinal tract.