Angiotensin-converting enzyme (ACE) inhibitors

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 and prevent kidney damage in people with high blood pressure or diabetes. They also benefit people who have had heart attacks.

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)

Eprosartan

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

Dizziness, headache, constipation, and nausea

This medication is used to treat people who continue to have symptoms of angina despite treatment with other drugs.

Blurred vision, chest discomfort, slow or fast heartbeat,headache, dizziness or fainting

This medication is used to treat symptoms of angina in some people who cannot take beta-blockers.

Anticoagulants

Tinzaparin

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 or who have had a heart attack.

Antiplatelet medications

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

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

Dizziness

Fluid accumulation (edema) in the ankles

Flushing

Headache

Heartburn

Enlarged gums

Abnormal heart rhythms (arrhythmias)

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

Glycoprotein IIb/IIIa inhibitors (a type of antiplatelet medication)

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

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

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

Few serious side effects

hyperlipidemia (including familial hypercholesterolemia), including people who have trouble tolerating other medications that lower cholesterol

Statins†

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

Anistreplase

Reteplase

Streptokinase

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.