ranolazine is kinda a new med that is used to treat angina. it's adjunct. however, if you're worried about orthostatic hypotension, you can use this. it's a newer drug with lesser side effects. There was one question on the exam that talks about this.  I wasn't so sure about it because there was another choice in which you can just not give Metoprolol that the pt has been taking for his HTN and use diltiazem instead - this is a wrong answer. However, since metoprolol is working for the pt, you don't want to d/c it (I questioned my instructor for this). Diltiazem tho has little if any vasodilation effects. Diltiazem works similarly to the beta blockers. so you don't want to use it because despite its little-if-any vasodilator effects, it could cause slowing heart rate. So, when you have orthostatic hypotension, what happens when you stand up? You feel dizzy and your heart beats faster to compensate for the drop in blood pressure. So, if you're on diltiazem, you're gonna put your pt at risk for too slow a heart beat. This could cause worsening of orthostatic hypotension. So, you wanna use Ranolazine to combat this.