Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Isosorbide”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1999

Optimal nitrate therapy with a once-daily sustained-release formulation of isosorbide mononitrate.

During long-term prophylaxis of angina with oral nitrates, sustained high plasma nitrate concentrations produce partial or complete tolerance to both the haemodynamic and the clinical effects of the drug. There is substantial evidence that this can be prevented by an adequate nitrate-free or nitrate-low period during each 24 h dosing interval. However, a nitrate-free interval carries the risk of a rebound increase in myocardial ischaemia. Once-daily formulations of isosorbide mononitrate deliver high plasma nitrate concentrations that improve exercise tolerance in patients with angina for at least 12 h after dosing. During the remainder of the dosage interval, plasma nitrate concentrations fall but are sufficient to protect against coronary artery spasm overnight. Myocardial ischaemia has a marked circadian rhythm. All ischaemic events (total ischaemic burden, myocardial infarction and sudden cardiac death) are most frequent in the hours immediately after waking. Oral anti-ischaemic prophylaxis should ideally provide protection during this critical period, in order to minimize symptoms, maximize exercise capacity and perhaps also to reduce the risk of clinical events. The ideal long-acting nitrate formulation should therefore provide a rapid rise in plasma nitrate concentration as well as maintaining prolonged efficacy throughout the dosing interval. Elantan LA is a sustained-release capsule formulation of isosorbide mononitrate for once-daily dosing. This capsule contains pellets which release 30% of the dose immediately, while 70% is released slowly to maintain the therapeutic response. The pharmacokinetic profile of this formulation prevents the development of tolerance, while also conferring long-term anti-anginal efficacy. Patients reported an improvement in both severity of angina and quality of life indices when their therapy was changed from multiple daily dosing with isosorbide dinitrate to once-daily dosing with Elantan LA (50 mg). The anti-anginal effect of Elantan LA is attained rapidly after dosing. Within 30 min of ingestion, there are clinically significant improvements in exercise tolerance, comparable with the speed of onset after an immediate-release formulation of isosorbide mononitrate. Elantan LA is an effective once-daily prophylaxis for angina which also produces a rapid onset of therapeutic effect. The release profile of this formulation maximizes protection against the morning surge in myocardial ischaemia.

Angina Pectoris↗
PubMed2001

Influence of endothelium in dose-dependent inhibition and potentiation by isoniazid of isosorbide dinitrate relaxation of rat aorta.

The influence of in vivo administration of isoniazid on the relaxant effect of isosorbide dinitrate was determined by pretreating rats with various doses of isoniazid and obtaining concentration-response curves to isosorbide dinitrate in aortic rings from these animals. In rings with endothelium, isoniazid potentiated responses to isosorbide dinitrate at doses of 10, 30, and 100 mg/kg; 3 and 300 mg/kg were without effect. In endothelium-denuded preparations, potentiation was present only at 10 mg/kg; 3 and 300 mg/kg inhibited relaxation. Other experiments indicated that isoniazid potentiation was prevented by pyridoxine, was reproduced with theophylline, and did not occur with 3-morpholinosydnonimine or papaverine. These results were deemed compatible with the hypothesis that isoniazid inhibits transsulfuration of homocysteine and causes its accumulation in vascular smooth muscle and endothelial cells, where it functions as a thiol intermediate and leads to enhanced bioactivation of isosorbide dinitrate. Potentiation appeared to occur only with moderate increases of homocysteine.

Animals↗
PubMed1992

Short report: comparison of the effects of sublingual nifedipine and isosorbide dinitrate on oesophageal emptying in patients with Chagasic achalasia.

The effects of sublingual nifedipine and isosorbide dinitrate on oesophageal emptying were compared in 11 patients with Chagasic achalasia. The oesophageal emptying of a radiolabelled test meal was assessed three times in each patient by a scintigraphic technique. No treatment preceded one of the studies (basal study). Nifedipine (20 mg) by the sublingual route 30 min before the meal, preceded one study. Isosorbide dinitrate, 5 mg by the sublingual route 5 min before the meal, preceded the third study. The order of the studies was allocated randomly for each patient. Oesophageal retention at the completion of the meal was significantly less (P less than 0.01) after isosorbide dinitrate (median: 54%, range: 5-87%) than after sublingual nifedipine (median: 78%, range: 7-99%) or after the control study (median: 83%, range: 5-100%). This difference persisted up to 20 min after the meal. Values measured in the control study and after sublingual nifedipine were not different (P greater than 0.10). These results show that isosorbide dinitrate, but not sublingual nifedipine, enhances oesophageal emptying in Chagasic achalasia.

Administration, Sublingual↗
PubMed1995

Inhibition of angiogenesis, tumour growth and metastasis by the NO-releasing vasodilators, isosorbide mononitrate and dinitrate.

1. The effect of the nitric oxide (NO)-producing nitrovasodilators isosorbide mononitrate (ISMN) and isosorbide dinitrate (ISDN) were assessed on (a) the in vivo model of angiogenesis of the chick chorioallantoic membrane (CAM) and (b) on the growth and metastatic properties of the Lewis Lung carcinoma (LLC) in mice. 2. Isosorbide 5-mononitrate (ISMN) and isosorbide dinitrate (ISDN), inhibited angiogenesis in the CAM dose-dependently. ISMN was more potent in inhibiting this process. Both compounds were capable of completely reversing the angiogenic effect of alpha-thrombin. These effects of ISMN and ISDN on angiogenesis were comparable to those previously observed with sodium nitroprusside which generates NO non-enzymatically. 3. Mice, implanted intramuscularly with LLC, received daily i.p. injections of ISMN for 14 days resulting in a significant decrease in the size of the primary tumour and a reduction in the number and size of metastatic foci in the lungs. ISDN had a similar but less pronounced effect than that observed with ISMN. 4. Addition of ISMN or ISDN to cultures of bovine, rabbit and human endothelial cells and to cultures of LLC cells had no effect on their growth characteristics. 5. These results indicate that ISMN and ISDN inhibit angiogenesis and tumor growth and metastasis in an animal tumour model. The possibility should therefore be considered that these nitrovasodilators which are widely used therapeutically and have well characterized pharmacological profiles, may also possess antitumour properties in the clinic.

Animals↗
PubMed1988

The sorption of isosorbide dinitrate to intravenous delivery systems.

The sorption of isosorbide dinitrate from 0.9% sodium chloride and 10% glucose solutions, by intravenous delivery systems has been investigated under simulated infusion conditions. Isosorbide dinitrate was stable in both 0.9% sodium chloride and 10% glucose solutions. Intravenous fluid containers, burettes, a syringe, infusion sets and end-line filters were evaluated. Glass containers, methacrylate butadiene styrene burettes and polybutadiene giving sets did not sorb isosorbide dinitrate. Neither did polypropylene syringes when a 10% glucose solution was used. The sorption of isosorbide dinitrate to end-line filters was unimportant but there was a significant loss to the PVC tubing used to connect the filter housing to the catheter.

Adsorption↗
PubMed1991

Influence of standard and nicotine-reduced cigarette smoke on plasma concentrations of isosorbide dinitrate and its metabolites in rats.

Rats dosed orally with isosorbide dinitrate (1 mg kg-1) were exposed to smoke from standard and nicotine-reduced cigarettes for 8 min using a smoking machine. Plasma concentrations of isosorbide dinitrate and 5-isosorbide mononitrate, one of its major metabolites were approximately equal in the exposed groups, but were lower than in the non-smoking control group. The 2-isosorbide mononitrate concentration was also lower in the group exposed to smoke from standard cigarettes. Since the pharmacokinetics were influenced by smoke from both types of cigarette smoke, the effect may be attributed in large part to non-nicotine components of the smoke.

Animals↗
PubMed1981

Vasodilator treatment with isosorbide dinitrate and hydralazine in chronic heart failure.

Several reports have suggested that because isosorbide dinitrate and hydralazine have different and additive haemodynamic effects at rest in patients with chronic heart failure, these agents should be administered in combination. Some studies, however, indicate thay they are effective individually as well. Since most patients with heart failure are symptomatic only with activity, we examined the haemodynamic effects of these drugs given individually and in combination, at rest and during upright bicycle exercise. As has been noted previously, at rest isosorbide significantly lowered both ventricular filling pressures and did not change cardiac output; hydralazine increased cardiac output and had only a slight effect on pulmonary capillary wedge pressure; combined treatment produced both beneficial effects. In contrast, during exercise isosorbide dinitrate also raised cardiac output while hydralazine more dramatically lowered the wedge pressure. Combined treatment produced significantly greater improvement in each haemodynamic index than either drug alone, with a resulting 54 per cent increase in exercise cardiac output, and a 33 per cent reduction in exercise wedge pressure. Maximal oxygen consumption increased acutely during combined treatment. These findings suggest that isosorbide dinitrate and hydralazine may each be effective in some patients, but that they are even more beneficial in combination.

Adult↗
PubMed1987

An evaluation of the effects of isosorbide 5-mononitrate in patients with angina on effort using dynamic electrocardiography and echocardiography.

We studied 14 patients, 9 males and 5 females, with an average age of 53.6 +/- 9.2 years, having been suffering from effort angina for over 6 months, with positive ergometer test for angina and ST-segment depression greater than 1 mm. All the patients performed a washout period of 7 days at the end of which, before and after acute administration (90 min) of isosorbide 5-mononitrate or placebo some echocardiographic parameters were controlled according to a double-blind, randomized, crossover design. Moreover, after 2 months of open treatment with isosorbide 5-mononitrate (20 mg three times daily), echocardiographic parameters were investigated again. Continuous ECG monitoring (24 h) was performed after the washout period and after 2 months of treatment. After acute administration of isosorbide 5-mononitrate, we observed a reduction in pre- and afterload, whereas after 2 months of treatment the reduction in preload seems to play a more important role. Together with other mechanisms these haemodynamic changes are responsible for the substantial diminution of myocardial oxygen consumption, and consequently for the reduction of transient ischaemic episodes, both symptomatic and asymptomatic with heart rate increase. These results suggest that isosorbide 5-mononitrate exhibits a definite nitrate-typical vascular activity that is evident both after single administration and after 2 months of treatment.

Angina Pectoris↗
PubMedDate not supplied

Efficacy of long-term administration of isosorbide for Ménière's disease.

The long-term therapeutic efficacy of isosorbide, an oral hyperosmotic diuretic, was clinically evaluated in 30 patients (14 males and 16 females) who were followed up in our clinic for more than 2 years. The patients ranged in age from 14 to 73 years, with a mean age of 49.2 years. Isosorbide was given orally, continuously or intermittently, for 27-297 weeks, depending on each patient's condition. The efficacy of the drug was determined according to the evaluation criteria of the American Academy of Ophthalmology and Otolaryngology (AAOO) and the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS) for Ménière's disease. Definitive episodes were successfully controlled in 15 of the 20 patients (75%) who received isosorbide continuously according to both the AAOO and the AAO-HNS criteria. Of the 10 patients who were given the drug intermittently, definitive episodes were successfully controlled in 6 patients (60%) according to the AAOO and in 7 patients (70%) according to the AAO-HNS criteria. During the treatment periods, hearing improved in 6 patients (20%), and tinnitus subjectively lessened in 15 patients (50%). Although some patients complained of abdominal discomfort, the side effects of this drug were minimal. Among the patients who responded well to the treatment, the doses of isosorbide could be tapered to a daily dose of 30 ml, less than one half of the usual daily of this drug. The results suggest that most patients should be asked to continue this medical treatment for at least several months before a decision can be made regarding whether the medical response is good or poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed2003

Effects of isosorbide mononitrate and AII inhibition on pulse wave reflection in hypertension.

The aortic pulse wave contour in isolated systolic hypertension often shows a prominent reflection peak, which combines with the incident wave arising from cardiac ejection so as to widen pulse pressure. We investigated the effects of an extended-release nitrate preparation and of 2 angiotensin II (AII) inhibitors (an AII receptor antagonist and an ACE inhibitor) on the aortic pulse wave contour and systemic blood pressure in hypertensive subjects with high augmentation index caused by exaggerated pulse wave reflection. Two double-blind, randomized, placebo-controlled crossover studies were carried out in a total of 16 elderly patients with systolic hypertension resistant to conventional antihypertensive therapy. In 1 study, pharmacodynamic responses to single doses of placebo, isosorbide mononitrate, eprosartan, and captopril were determined; in the other, single-dose isosorbide mononitrate and placebo were compared in subjects treated with AII inhibitors at baseline. Blood pressure was measured by sphygmomanometry and pulse wave components by applanation tonometry at the radial artery. All 3 agents were shown to decrease brachial systolic blood pressure, aortic systolic blood pressure, and aortic pulse pressure. Qualitative effects on the aortic pulse wave contour differed: augmentation index was not significantly altered by either captopril or eprosartan but was decreased (P<0.0001) by approximately 50% of the placebo value with isosorbide mononitrate in both study groups. We propose that isosorbide mononitrate corrected the magnified wave reflection in systolic hypertension of these elderly patients by an effect that was distinct from that exercised by either acute or chronic AII inhibition.

Acrylates↗
PubMed1987

Antithrombogenic endothelial cell defense. Basal characteristics in cultured endothelial cells and modulation by short-term and long-term exposure to isosorbide nitrates.

The antithrombogenic endothelial cell defense (ATECD) describes the properties that enable the endothelium to prevent circulating blood platelets from adhering to, or aggregating on, the vascular wall. ATECD was investigated in an experimental model in which bovine passage 0 cultured endothelial cells (EC) were incubated with aggregating platelets and autologous plasma in a computer-operated aggregometer-like device. A maximal platelet aggregation required 150 X 10(-6) M adenosine diphosphate (ADP) to be present in ECs. A 5-minute coincubation for ECs and platelets was found to be adequate in evaluating the maximal ATECD value. By increasing the EC number in the aggregation suspension, platelet aggregation was progressively inhibited through a sigmoid curve (50% inhibition of aggregation required 2 X 10(4) EC). Pharmacologic modulations of ATECD by isosorbide dinitrate (ISDN) + 2-isosorbide mononitrate (2-ISMN) + 5-isosorbide mononitrate (5-ISMN) were investigated under experimental conditions reflecting either an acute nitrate effect (platelet + control ECs + drug + ADP) or a chronic effect (platelet + 5-day nitrate-treated ECs + ADP). Under acute circumstances, ISDN antiplatelet activities were profoundly magnified by ECs. Aggregation was fully arrested with 5 X 10(-5) M ISDN and an EC number of 2 X 10(4), whereas the same ISDN concentration alone induced 30% inhibition of control aggregation. In contrast, there were no significant changes in platelet aggregation whether incubation was done in the presence or absence of 2-ISMN or 5-ISMN, ISDN metabolites. Long-term exposure of ECs to isosorbide nitrates (ISN) resulted in increased acquired EC changes in ATECD. 5-ISMN was a poor antiplatelet agent but was capable of counteracting ISDN effects on ATECD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Diphosphate↗
PubMedDate not supplied

Effect of sustained-release isosorbide dinitrate on post-prandial gastric emptying and gastroduodenal motility in healthy humans.

Nitric oxide (NO) is an inhibitory neurotransmitter released by non-adrenergic and non-cholinergic neurons that innervate the smooth muscles of the gastrointestinal tract. We examined whether NO, derived from a sustained-release preparation of isosorbide dinitrate, influenced gastric emptying and gastroduodenal motility after a meal. Eleven healthy volunteers participated in a double-blind, placebo-controlled, cross-over study. Each subject ingested 40 mg isosorbide dinitrate orally as a sustained-release formulation or oral placebo, in random order. Gastric emptying and gastroduodenal motility were measured using scintigraphic and manometric techniques. Isosorbide dinitrate did not change the area under the curve of gastric retention versus time, and did not influence the frequency of antral contractions as assessed at 15-min intervals or the integrated duodenal motility index, as recorded over consecutive 15-min periods. A 40 mg single dose of sustained-released isosorbide dinitrate does not seem to alter gastric emptying or gastroduodenal motility after a meal.

Administration, Oral↗
PubMed2005

Isosorbide dinitrate and hydralazine hydrochloride: a review of efficacy and safety.

In the USA alone, there are over 5,000,000 people diagnosed with heart failure. A disproportionate number of African-Americans are affected by this disease, with increased morbidity and mortality, yet they are tremendously under-represented in clinical trials. Several drugs have been approved for use in heart failure based on clinical trials, with percentages of African-American subjects as low as 1%. In the African-American Heart Failure Trial the use of BiDil, a drug combining isosorbide dinitrate and hydralazine hydrochloride, demonstrated a 43% decrease in overall mortality and a 39% decrease in first hospitalization. The combination consists of 20 mg of isosorbide and 37.5 mg hydralazine hydrochloride in a fixed dose that functions as a nitric oxide enhancer and an antioxidant, and helps to prevent tolerance to the prolonged use of nitrate. The hemodynamic effects of the combination drug in heart failure includes increased cardiac output. The US Food and Drug Administration approved the combination of isosorbide dinitrate based on the African-American Heart Failure Trial. Further clinical trials utilizing isosorbide dinitrate will hopefully determine the benefit of this combination in a larger population, including caucasians and other racial/ethnic groups.

Black or African American↗
PubMed2000

Tilt testing in neurocardiogenic syncope: isosorbide versus isoproterenol.

OBJECTIVE: To compare the diagnostic value of pharmacological stimulation with sublingual isosorbide dinitrate and intravenous isoproterenol during tilt testing in patients with neurocardiogenic syncope and with a negative tilt test without pharmacological provocation. METHODS AND RESULTS: One hundred and twenty patients with a history of neurocardiogenic syncope (aged 15 to 77 years) and 50 healthy volunteers (aged 25 to 70 years) were prospectively submitted to head-up tilt (HUT). Those who did not develop syncope or presyncope during passive HUT for 30 minutes underwent repeated HUT with isoproterenol infusion at 4 microg/min (ISOP HUT), for 10 minutes, and, subsequently, were tilted after sublingual administration of 5 mg of isosorbide dinitrate (ISDN HUT) for another 12 minutes. ISDN HUT was always performed after ISOP HUT. Sensitivity and specificity of passive HUT were 41% (95% C.I. 32.9% to 51.0%) and 100%, respectively. Sensitivity of ISOP HUT was 51.4% (95% C.I. 39.2% to 63.6%) and specificity 70% (95% C.I. 55.4% to 82.1%) and for ISDN HUT were 70% (95% C.I. 57.9% to 80.4%) and 88% (95% C.I. 75.7% to 95.5%), respectively. The accuracy of ISDN HUT was significantly higher than the accuracy of ISOP HUT 77.5% (95% C.I. 68.9% to 84.6%). There were fewer side effects during ISDN HUT. CONCLUSION: Sublingual isosorbide dinitrate is at least as sensitive as isoproterenol to assess patients with suspected neurocardiogenic syncope and with a negative tilt test without provocation. The low rate of side effects and the higher accuracy of ISDN HUT, along with the simplicity of this challenge compared to ISOP HUT, suggest that sublingual isosorbide dinitrate should be preferred as a provocative agent to evaluate neurocardiogenic syncope after a negative passive tilt test.

Administration, Sublingual↗
PubMed1992

[Effect of isosorbide dinitrate on vasomotricity-cytosolic calcium coupling during aging in the rat].

Simultaneous measurement of vasomotricity and variations of cytosolic calcium concentrations (mobilisation of intracellular calcium) on a preparation of a normotensive Wistar rat caudal artery allowed analysis of the vasomotricity-cytosolic calcium coupling with respect to age and after administration of isosorbide dinitrate. Vasomotricity was evaluated from changes in perfusion pressure (delta P) of arterial segments perfused at a steady flow state. These segments were exposed to a fluorescent probe, fura 2, the variations of the intensity of emission of which, at wave lengths of 340 and 380 nm, reflect variations in cytosolic calcium concentration (delta R%). The "efficacy" of the vasomotricity-cytosolic calcium coupling was estimated from the delta P/delta R% ratio. In the rat, ageing is accompanied by a reduction in vasomotricity and efficacy of the coupling during noradrenalin stress testing. However, these two parameters recorded during contractions induced by the calcium in a depolarising medium do not change with age. Isosorbide dinitrate reduces vasoconstriction and the delta P/delta R% ratio during noradrenalin stimulation in the young rat. The effect is less pronounced in older rats. Isosorbide dinitrate also reduced the vasomotricity and efficacy of coupling but to a lesser degree during vaso-constriction induced by the calcium in a depolarising medium, without changing the mobilisation of intracellular calcium irrespective of the age of the animals. In conclusion, ageing seems to affect the vasomotricity-cytosolic calcium coupling mainly during receptor stimulation (noradrenalin) rather than during depolarising stimulation (calcium in a depolarising medium). Isosorbide dinitrate acts mainly on the same depolarising stimulation, independent of age.

Aging↗
PubMed2005

The effect of a combined treatment with propranolol and isosorbide-5-mononitrate on Doppler ultrasound parameters in patients with cirrhosis and portal hypertension.

OBJECTIVES: The objectives of this study were to compare the effect of the treatment with propranolol to that with propranolol and isosorbide-5-mononitrate in portal hypertension, as assessed by Doppler ultrasound parameters in patients with cirrhosis. METHODS: A prospective study of two groups, each of 30 patients with cirrhosis Child-Pugh A was performed. In one group 40 mg/day propranolol were administered for 6 months and in the other, a combined treatment with propranolol 40 mg/day and isosorbide-5-mononitrate 40 mg/day was administered for 6 months. In all patients the presence of esophageal varices was confirmed by upper gastrointestinal endoscopy and abdominal ultrasonography and Doppler ultrasonography of the portal vein was performed. The patients were monitored for: the velocity of blood flow in the portal vein, the cross sectional area of the portal vein and the portal vein congestion index. Data analysis used t-Student test, Pearson and Spearman correlation. A p value of <0.05 was considered to be significant. RESULTS: A significant decrease of all parameters after 6 months was observed in the group with combined therapy with propranolol and isosorbide-5-mononitrate (p<0.05). The relative decrease of the cross sectional area of the portal vein and of the portal vein congestion index was more important when patients had higher initial values of the two parameters, indicating an increased hemodynamic impairment (Pearson, p<0.001). In patients treated only with propranolol, the relative decrease correlated with its initial value for all parameters. CONCLUSION: The combined therapy with propranolol and isosorbide-5-mononitrate proved to be superior to the mono-therapy with propranolol in decreasing the hemodynamic parameters in portal hypertension, probably by an additive effect.

Adrenergic beta-Antagonists↗
PubMed1991

Clinical response and effects on left ventricular function of isosorbide dinitrate added to propranolol or diltiazem monotherapy in patients with chronic stable angina.

Twenty-four patients were randomized to a double-blind, triple placebo controlled, latin square protocol to examine the relative efficacy of propranolol or diltiazem given as monotherapy or in combination with isosorbide dinitrate. Treatment phases were preceded and followed by placebo control periods. At the end of each phase, symptom-limited treadmill exercise stress tests were performed, as well as rest and exercise radionuclide ventriculography. Both forms of monotherapy were effective in reducing episodes of angina and nitroglycerin use, and in improving exercise tolerance. Diltiazem monotherapy was associated with slightly higher treadmill times (509.9 +/- 123 s) compared to propranolol (462.7 +/- 131 s, P less than 0.05). The addition of isosorbide dinitrate to either form of monotherapy allowed no further improvement in any of the measured clinical responses. Radionuclide ventriculography showed no significant difference in resting left ventricular function. The addition of isosorbide dinitrate to propranolol showed a reduction in end diastolic volume in keeping with a reduction in preload. In response to exercise, stress-induced left ventricular dysfunction was equal in all groups except for the diltiazem-nitrate combination, which was associated with a higher ejection fraction (56.2 +/- 8.6%) compared to monotherapy (52.6 +/- 10.9%, P less than 0.01). A higher cardiac output could be achieved in the groups treated with diltiazem; this was related to increased heart rate and maintenance of stroke volume. It was concluded that diltiazem is equally effective as propranolol for the treatment of chronic stable angina and, in terms of exercise capacity and cardiac output, superior to beta-blockade. The addition of isosorbide dinitrate appears to impart no overt benefits, but some evidence suggests a reduction in left ventricular decompensation in the face of stress.

Adult↗
PubMed1988

[Molsidomine and isosorbide dinitrate:/their comparative effectiveness in patients with exertion-induced stenocardia].

The markedness and duration of antianginal effects of 2 mg molsidomine and 10 mg isosorbide dinitrate were compared by means of repeated treadmill tests in 37 coronary patients with stable angina of effort. Peak magnitude of the effect was similar with both drugs, while the duration of the effect of isosorbide dinitrate (4.0 +/- 0.3 hrs) was significantly greater than that of molsidomine (3.4 +/- 0.3 hrs). Molsidomine reached its peak effect significantly earlier, as compared to isosorbide dinitrate. There was a significant correlation between the effectiveness of molsidomine and isosorbide dinitrate in the same patients.

Angina Pectoris↗