Benidipine is an orally triple L-, T-, and N-type calcium channel blocker for the treatment of hypertension and angina pectoris synthesized and developed by Kyowa Hakko Kogyo Co., Ltd. Benidipine, approved in Japan in November 1991, has become one of the three best selling CCBs and is highly useful as a potent, long-lasting antihypertensive and antianginal agent.

Perhexiline, 2-(2,2-dicyclohexylethyl)piperidine, is an anti-anginal drug. Perhexiline reduces fatty acid metabolism through the inhibition of carnitine palmitoyltransferase, the enzyme responsible for mitochondrial uptake of long-chain fatty acids. Perhexiline is used for reducing the frequency of moderate to severe attacks of angina pectoris due to coronary artery disease in patients who have not responded to other conventional therapy or in whom such therapy may be contraindicated. Heart Metabolics Limited is developing perhexiline for the treatment of hypertrophic cardiomyopathy

Flunarizine is a selective calcium entry blocker with calmodulin binding properties and histamine H1 / dopamine D2 blocking activity. It is not available in the US but marketed in other countries for prophylaxis of a migraine, occlusive peripheral vascular disease, the vertigo of central and peripheral origin, motion sickness and as an adjuvant in the therapy of epilepsy. The drug is also investigated for the treatment of schizophrenia.

In the US, Ethaverine is a member of the drug class peripheral vasodilators. It’s an alkaloid prepared synthetically from opium with no narcotic properties. Directly relaxes all smooth muscles, especially when they have been spasmodically contracted. Action is especially pronounced when spasm is present on coronary, cerebral, pulmonary, and peripheral arteries. Acts directly on myocardium like quinidine; depresses conduction and irritability, and prolongs refractory period. Primarily for peripheral and cerebral vascular insufficiency associated with arterial spasm; also a smooth muscle spasmolytic in spastic conditions of the GI and GU tracts. Adverse Effects ( 1%) CNS: Vertigo, headache, drowsiness. CV: Hypotension, arrhythmias. GI: Nausea, anorexia, abdominal distress, dry throat. Other: Malaise, flushing, sweating, lassitude, respiratory depression. Ethaverine may decrease levodopa effectiveness; morphine may antagonize smooth muscle relaxation effect of ethaverine.