Verapamil in treatment of chronic stable angina

Verapamil, a calcium-entry blocking drug, is now available in the United States for the treatment of chronic stable angina. The effectiveness of the drug in obstructive coronary disease is dependent on a complex interplay of its direct actions and the reflex phenomena that they elicit. Clinical trials have demonstrated that the efficacy and safety of verapamil in treating patients with effort-related angina compares favorably with that seen with other antianginal agents. Relative contraindications to the use of verapamil include left ventricular dysfunction and sinus node and atrioventricular conduction disease. Combination therapy of beta-blockers with verapamil can provide important therapeutic benefits for many patients but it carries with it the potential for serious adverse reactions and, thereby, patients need to be carefully selected for such therapy. Verapamil is proving to be an important addition to existing drug regimens available for the treatment of stable angina pectoris.