Coronary vasospasm: A narrative review

Table 1 Pharmacologic therapies for coronary artery vasospasm

Drug class	Common drugs	Usual drug dosage	Indication
CCB	Amlodipine; Diltiazem; Nifedipine-ER	10 mg qD; 240 mg qD; 30-120 mg qD	First line for CAVS[40-42]
Long-acting nitrate	Isosorbide mononitrate	60–240 mg qD (maintenance)	Symptomatic improvement in combination with first line therapy[2]
Short-acting nitrate	Sublingual nitroglycerin	0.3 mg	Acute attack[43]
Statin	Lovastatin; Fluvastatin	80 mg qD; 20-80 mg qD	All patients experiencing CAVS[15,44]
ACE inhibitor/ARB	Candesartan; Losartan	8-16 mg qD; 25–50 mg qD	All patients experiencing CAVS[45]
BB	Bisoprolol; Nebivolol	1.25–5 mg qD; 5–10 mg qD	DES-VSA[37,38]
Rho kinase inhibitors	Fasudil	240 mg qD	Refractory CAVS[46]
Antioxidants	Vitamin E	400 mg qD	Adjunct therapy[47]
Magnesium	Magnesium Chloride	20 mEq	Replenishing deficiency[5]
Potassium channel activator	Nicorandil	10–20 mg BID	If nitrates are ineffective[12]

CCB: Calcium channel blocker; ACE: Angiotensin converting enzyme; ARB: Angiotensin II receptor blocker; BB: Beta blocker; DES-VSA: Drug-eluting stent-induced vasospastic angina; CAVS: Coronary artery vasospasm; qD: Daily; BID: Twice a day.