The different types of antianginal drugs most commonly include nitroglycerin, beta-blockers and calcium channel blockers. Antianginal drugs are used to treat angina pectoris, the medical term for chest pain. These medications may be used alone, in combination with each other, or along with other medications.
Angina pectoris, often simply called "angina," causes discomfort in the chest that may be felt as pressure, tightness, squeezing, or a feeling of heaviness. The pain can radiate throughout the neck, jaw, back, arms and teeth. Angina pectoris is caused by a decreased supply of blood oxygen to part of the heart, often the result of narrow or clogged arteries. Additional symptoms may include indigestion, nausea, sweating, and cramping.
Physical exertion can increase the risk of angina pectoris. Nitroglycerin, one of the most commonly used antianginal drugs, can help prevent or reduce the risk of chest pain during physical activities. Nitroglycerin comes in extended-release tablets, sublingual tablets, and spray form. The medication is typically taken before engaging in physical activity. Extended-release tablets may prevent angina, but cannot be used to treat an episode once it has started.
Beta-blocker antianginal drugs work by inhibiting adrenaline’s effect on the heart and reducing the heart’s oxygen demand. The medication helps lower blood pressure and reduces the force of blood pumping through the heart muscle. Beta-blockers are typically used in combination with other types of antianginal drugs, and usually only after other medications fail to work.
Calcium channel blockers help relax and widen blood vessels by acting on the cells in the walls of the vessels. In turn, this increases blood flow to the heart, which relieves chest pain. This antianginal drug comes in both short-acting and long-acting forms. The short-acting form works quickly but only lasts a few hours. Long-lasting calcium channel blockers provide more long-term relief, but do not act as quickly when an attack occurs.
Antianginal drugs can cause various side effects. Nitroglycerin may cause dizziness or fainting- especially when suddenly changing positions, flushing of the face, nausea, and vomiting. Common side effects of beta-blockers include headache, constipation or diarrhea, upset stomach, fatigue, and dizziness. Calcium channel blockers include the same side effects as beta-blockers plus rapid heart rate and swelling of the legs or feet.
A physician will determine the best type of antianginal drug based on the patient’s medical history and individual characteristics. Beta-blockers and calcium channel blockers come in a wide variety of brands and forms; if one doesn’t work, another may be tried. If none of the medications work, more invasive procedures may need to be considered.