Statins, beta blockers, and long-acting nitrates are all useful in treating angina. So are aspirin and some of the newer anti-platelet drugs (Plavix, Brilinta, Effient are some of those). Is he on a long-acting Isosorbide drug (which contains a different longer-acting form of the nitroglycerine pill that he would use under his tongue for a prolonged angina episode)? Unfortunately, Ranexa (Ranolazine) is a new class of anti-anginal drug, and when insurance companies refuse to cover it, it is a problem. There is not as yet any substitute for it. It is a very effective drug at prolonging exercise tolerance and stamina, and delaying the onset of angina pains or shortness of breath. Find out if your doctor can obtain samples of the drug, or call the manufacturer, Gilead Pharmaceuticals, as they may have a program to provide financial aid or coupon discounts to help to pay for it. Another option is for you (either without, or hopefully, with your doctor s help) to appeal the insurance company s decision denying coverage of the Ranolazine/Ranexa. Ranolazine is especially helpful for those patients with multi-vessel blockages and small vessel blockages which are blocked enough to cause symptoms but too small or unreachable by catheter to be ballooned or stented. Other drugs that we can add on to the above might include calcium channel blockers, such as diltiazem or amlodipine, which may help also.