Drug therapy — Two classes of drugs, nitrates and calcium channel blockers, have LES muscle-relaxing effects. These drugs can decrease symptoms in people with achalasia. The drugs are usually taken by placing a pill under the tongue 10 to 30 minutes before meals.
Drug therapy is the least invasive and safest option for treating achalasia. However, most people find that long-term drug therapy is inconvenient, ineffective, and often associated with unpleasant side effects, such as headache and low blood pressure. Furthermore, the drugs tend to become less effective over time. For these reasons, medications are recommended primarily for patients who are not interested in or not healthy enough for mechanical treatments such as balloon dilation and surgery (myotomy).