Calcium channel blockers, or CCBs, and ranolazine are two important types of drugs used to treat angina pectoris.

CCBs block calcium channels in cardiac and smooth muscle cells and inhibit the influx of calcium ions, leading to vasodilation and reduced myocardial oxygen demand.

CCBs comprise dihydropyridines, such as nifedipine, phenylalkylamines, such as verapamil, and benzothiazepines such as diltiazem.

All CCBs that are administered orally undergo extensive metabolism. Drugs like verapamil and diltiazem can also be given via intravenous routes.

Side effects of CCBs include headache, dizziness, and peripheral edema.

Sodium-channel blockers like ranolazine inhibit the late-phase sodium current in cardiac cells during repolarization, which prevents calcium entry via the sodium-calcium exchanger. As a result, intracellular levels of sodium and calcium decrease, relaxing the cardiac muscle and improving coronary blood flow.

Ranolazine is well absorbed when taken orally and is primarily metabolized by CYP3A enzymes.

Common side effects of ranolazine include dizziness, headache, constipation, and nausea.