Examples | Some Side Effects | Comments |
---|---|---|
Angiotensin-converting enzyme (ACE) inhibitors | ||
Benazepril Captopril Enalapril Fosinopril Lisinopril Moexipril Perindopril Quinapril Ramipril Trandolapril | 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 Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or... read more and prevent kidney damage in people with high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more or diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more . They also benefit people who have had heart attacks Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more . 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) | ||
Candesartan Eprosartan Irbesartan Losartan Olmesartan Telmisartan Valsartan | 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 | ||
Ranolazine | Dizziness, headache, constipation, and nausea | This medication is used to treat people who continue to have symptoms of angina Angina Angina is temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. A person with angina usually has discomfort or pressure beneath the... read more despite treatment with other drugs. |
Ivabradine | Blurred vision, chest discomfort, slow or fast heartbeat,headache, dizziness or fainting | This medication is used to treat symptoms of angina Angina Angina is temporary chest pain or a sensation of pressure that occurs while the heart muscle is not receiving enough oxygen. A person with angina usually has discomfort or pressure beneath the... read more in some people who cannot take beta-blockers. |
Anticoagulants | ||
Argatroban Apixaban Bivalirudin Dabigatran Dalteparin Enoxaparin Fondaparinux Heparin Rivaroxaban Tinzaparin Warfarin | 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 Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more or who have had a heart attack. |
Antiplatelet medications | ||
Aspirin Clopidogrel Prasugrel Ticagrelor Ticlopidine | 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 | ||
Atenolol Bisoprolol Carvedilol Metoprolol | 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 | ||
Amlodipine Diltiazem Felodipine Nifedipine (sustained-release only) Verapamil | Dizziness Fluid accumulation (edema) in the ankles Flushing Headache Heartburn Enlarged gums Abnormal heart rhythms (arrhythmias) With 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. |
Glycoprotein IIb/IIIa inhibitors (a type of antiplatelet medication) | ||
Abciximab Eptifibatide Tirofiban | 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 dinitrate Isosorbide mononitrate Nitroglycerin | 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 | ||
Morphine | 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 | ||
Alirocumab Evolocumab | 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 hyperlipidemia Dyslipidemia Dyslipidemia is a high level of cholesterol and/or triglycerides or a low level of high-density lipoprotein (HDL) cholesterol. Lifestyle, genetics, disorders (such as low thyroid hormone levels... read more (including familial hypercholesterolemia), including people who have trouble tolerating other medications that lower cholesterol |
Statins† | ||
Atorvastatin Fluvastatin Lovastatin Pravastatin Rosuvastatin Simvastatin | 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 | ||
Alteplase Anistreplase Reteplase Streptokinase Tenecteplase | 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. |