Table 4.

Advice and dosing of medication for provocative coronary artery spasm testing

Prior to procedure:
Withhold for 48 h	Long-acting calcium antagonists
Withhold for 24 h	Caffeine
	Long-acting nitrates
	Short-acting calcium antagonists
	α-Blockers
	β-Blockers
	ACE inhibitor
	Angiotensin receptor blockers
	Renin inhibitors
	Aldosterone inhibitors
Withhold for 4 h	Sublingual nitrates
During procedure:
Agent	Administration	Dose
– Acetylcholine	Intracoronary (manual) bolus injection	LCA: 20/50/100/200 µg RCA: 20/50/80 µg over 20 s with an at least 3‑min interval between each injection
	Intracoronary (continuous) infusion	LCA or RCA: Incremental doses of 0.288/2.88/28.8/288 µg during 3 min (maximal highest dose 864 µg)
– Ergonovine	Intracoronary (continuous) infusion	LCA: 16 µg/min during 4 min (maximal dose 64 µg) RCA: 10 µg/min during 4 min (maximal dose 40 µg)
	Intravenous (continuous) infusion	Incremental doses of 50/100/150 µg during 5 min

ACE angiotensin-converting-enzyme, LCA left coronary artery, RCA right coronary artery