Medical Management

Not everyone who suffers from coronary artery disease (CAD) is destined for bypass surgery, or even angioplasty for that matter. In fact, the first treatment for the symptoms of CAD is often a nonsurgical approach. A variety of medications have been proven effective in decreasing the workload of the heart, reducing blood pressure, widening narrowed arteries, and improving oxygen supply to the heart.

Beta Blockers

Beta blockers (such as propranolol, metoprolol, nadolol, timolol, etc.) are often prescribed for controlling high blood pressure as well as for treating angina (chest pain). These drugs act by decreasing the heart rate, and reducing heart contraction. The result is that the heart’s need for oxygen is reduced, thereby decreasing the workload of the heart.


Coronary vasodilators (such as nitroglycerin, amyl nitrate, glyceryl trinitrate and other “nitrates”) relax smooth muscle and dilate or widen the blood vessels to allow a greater supply of oxygen-rich blood to the heart. They have the added effect of reducing blood pressure.

Calcium Entry Blockers

New types of drugs that are being used with great success in the treatment of angina are calcium entry blockers (also called calcium channel blockers). These drugs include nifedipine, verapamil, and diltiazem. Calcium entry blockers inhibit the movement of calcium into the heart muscle. This slows down heart rate (decreasing oxygen demand) and relaxes and widens coronary arteries; increasing oxygen supply. Calcium entry blockers are also being used for blood pressure control.

Treatment of Choice?

For selected patients, medical management is the treatment of choice for the symptoms of coronary artery disease. If your doctor feels that your symptoms can be successfully controlled by medication, be sure to follow his or her directions exactly. Never discontinue your medication without your doctor’s prior consent, and report any side effects-dizziness, nausea, etc.-immediately. While medications cannot “cure” coronary artery disease, for many people they can relieve symptoms.

–American Heart Association


Ranolazine is used with other medications to treat a certain type of chest pain (chronic stable angina) in patients whose angina has not been controlled by other treatments. It decreases the number of times you may get chest pain. Relieving symptoms of angina can increase your ability to exercise and perform strenuous work.

Ranolazine works differently than other drugs for angina, so it can be used with your other angina medications (e.g., amlodipine, beta blockers, nitrates). It is thought to work by improving how well the heart uses oxygen so that it can do more work with less oxygen.

How to use Ranexa Oral

Take this medication by mouth, usually twice daily with or without food or as directed by your doctor. Swallow the tablet whole. Do not crush or chew the tablets. Doing so will destroy the slow release of the drug, which may decrease its effectiveness and increase your risk of side effects.

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

The dosage is based on your medical condition and response to therapy. Do not take more than 1000 milligrams in a single dose or more than 2000 milligrams in 24 hours.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. This medication must be taken regularly to be effective. It should not be used to treat angina when it occurs. Use other medications (e.g., sublingual nitroglycerin) to relieve an angina attack as directed by your doctor. Consult your doctor or pharmacist for details.

Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition does not improve or if it worsens (e.g., your chest pain happens more often).


PLAVIX (clopidogrel bisulfate) is a prescription medicine that when taken daily can help reduce your risk of having a future heart attack or stroke. It is recommended for people who have suffered from a recent heart attack or recent stroke, or who have been diagnosed with peripheral artery disease, or P.A.D.—poor circulation in the legs that may cause pain during exercise, such as walking, and may be relieved by rest.*

PLAVIX (clopidogrel bisulfate), taken with aspirin, is also recommended for people who have Acute Coronary Syndrome (ACS), a diagnosis that includes heart-related chest pain (unstable angina) and the 2 types of heart attack—acute ST-segment elevation myocardial infarction (“STEMI” or “Q-wave” heart attack) and non–ST-segment elevation myocardial infarction (“NSTEMI” or “non–Q-wave” heart attack).

PLAVIX (clopidogrel bisulfate) helps keep platelets in the blood from sticking together and forming clots, which helps keep your blood flowing. This helps protect you from a future heart attack or stroke.

Always talk to your doctor before taking aspirin or other medicines with PLAVIX, especially if you’ve had a stroke.

*PLAVIX is not indicated for the treatment of symptoms of peripheral artery disease.

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