How is angina treated?
There are several different drugs available to treat angina. These drugs cannot cure angina but can relieve the discomfort of an attack or help to prevent an attack. There are two main types of drugs: those that increase the blood supply to the heart and those that reduce the workload of the heart. Tablets that dissolve under the tongue (sublingual tablets) or sublingual sprays can be used to treat angina attacks. Drugs used to prevent attacks may be given as tablets or as patches or ointment applied to the skin.

Nitrates relieve both stable and unstable angina by dilating the blood vessels. This dilation eases the workload of the heart and also widens the coronary arteries. Nitrates can be given to prevent an attack at night or prior to exercise. Nitroglycerin is a short-acting nitrate that is often used when an attack occurs. It is available as sublingual tablets, which are dissolved  under the tongue, or as a sublingual spray. Slow-release forms of nitroglycerin  are also available and can be used to treat and prevent attacks. Nitroglycerin  is also available in patches that are applied directly to the skin to prevent an attack and also as an ointment.

Isosorbide dinitrate (Dilatrate-SR, Isordil Titradose), and isosorbide mononitrate (Monoket) are longer-acting nitrates that are used mainly to prevent attacks. Isosorbide dinitrate is available as slow-release tablets to prevent angina attacks and as immediate-release tablets to treat and prevent of angina attacks. Isosorbide mononitrate is used to prevent an attack and is available as slow-release tablets or immediate-release tablets. For stable angina, commonly brought on by exercise, beta-blockers may be prescribed. These work by slowing down the heart rate, which in turn reduces the workload of the heart. When taken regularly, they can reduce the frequency of angina attacks. Beta-blockers include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Ziac), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), pindolol, propanolol (Inderal) and timolol.

Calcium-channel blockers can also reduce the frequency of angina attacks. These drugs act by causing relaxation of the coronary arteries and also the heart muscle, thereby lowering blood pressure and reducing the workload of the heart. Calcium channel blockers include amlodipine (Norvasc), diltiazem (Cardizem), felodipine (Plendil), nicardipine, nifedipine (Procardia), nisoldipine (Sular) and verapamil (Calan, Covera-HS).