Published online Mar 26, 2018. doi: 10.4330/wjc.v10.i3.15
Peer-review started: November 24, 2017
First decision: December 27, 2017
Revised: January 12, 2018
Accepted: February 6, 2018
Article in press: February 6, 2018
Published online: March 26, 2018
Processing time: 119 Days and 3 Hours
It is well known that calcium channel blockers (CCBs) are the first line of therapy for vasospastic angina (VSA). Here, we report two cases of VSA with an increase in the frequency of angina attacks after switching from a brand-name to a generic CCB. In both cases, angina recurred upon switching from a brand-name CCB to a generic CCB during follow-up. The patients’ condition improved upon switching back to the original CCB. Both cases involved a high severity of VSA, based on the results of spasm provocation testing. These findings suggest that, in some patients with severe VSA, the frequency of angina attacks increases when switching from a brand-name CCB to a generic CCB. Cardiologists should consider this factor when prescribing drugs for angina.
Core tip: Calcium-channel blockers (CCBs) are the first line of therapy for vasospastic angina (VSA). Here, we report two cases of VSA with an increase in the frequency of angina attacks after switching from a brand-name to a generic CCB. Switching back to the original CCB improved the patients’ condition in both cases. Both cases involved highly severe VSA. It is important for cardiologists to check whether VSA patients who have refractory angina attacks while taking a CCB are taking a brand-name or generic CCB.