Objective: To review the cardiovascular medications therapeutic interchanges. Methods: It is an extensive search, or fifty databases included the following through the Saudi Digital Library (SDL) searching engine. It included the various types of studies (meta-analysis, randomized controlled studies and observational studies) in the English language with human study only for the update May 2017. The search in terms of therapeutic interchange, medication, therapy, type of disease or medication base on therapeutics class of anti-psychiatric. The medication list and switch from one drug to alternative based on the literature found the search that has included comparative safety, efficacy and cost of the type of medication for each disease and national or international evidence-based guidelines. Results: The total number of studies after an extensive search with a specific term search was 487 studies. Of those, there were 107 duplicated studies, and 380 studies included for future evaluation. After evaluation, there were 64 studies about therapeutic interchange of cardiovascular medications. Conclusion: The cardiovascular therapeutic interchange studies are wide-ranging and common available findings in the literature. Most of the studies have observational non-randomized. Comparative studies published in management guidelines as an alternative interchange of this matter. Cardiovascular therapeutic interchanges are highly recommended for execution in the Kingdom of Saudi Arabia.