Harvard Heart Letter

Heart Beat: FDA okays new drug for tough-to-treat chest pain

Heart Beat

FDA okays new drug for tough-to-treat chest pain

A new drug approved in January 2006 could offer relief for the thousands of Americans with chest pain (angina) that isn't controlled by standard drug therapy.

Ranexa (ranolazine) is the first new drug approved for angina since the mid-1990s. The older standbys — beta blockers, nitrates, and calcium-channel blockers — either slow the heart so it needs less oxygen or open blood vessels so they can deliver more oxygen-rich blood. "Ranexa comes at angina from a completely different direction," says Dr. Peter H. Stone, co-director of the cardiac care unit at Harvard-affiliated Brigham and Women's Hospital. It prompts heart cells to burn sugar instead of fat. This takes less oxygen per unit of energy generated, an important saving when parts of the heart aren't getting enough oxygen.

Ranexa doesn't work miracles. In two large clinical trials, the drug didn't eliminate angina. But it did reduce the number of weekly attacks.

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