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The exercise tolerance and plasma concentration of a long acting isosorbide dinitrate (ISDN) NRR were studied in 6 patients with stable effort angina after 6 hr of therapywith 20 mg of NRR using symptom-limited multistage ergometer exercise. The results weresummarized as follows.(1) The initiation time of chest pain was significatly prolonged (P<0.05) with animproved work tolerance after a single oral dose of NRR 20 mg.(2) A peak of mean plasma concentration of ISDN was reached at 4 hr after a singleoral dose of NRR 20 mg, and its concentration level over 20 ng/ml persisted for 2-6 hr.Moreover, 42% of the peak plasmaconcentration of ISDN was noted at 8 hr after dosing.(3) Against the same work load and double product ST depression was significantlyimproved after administration as compared to that before dosing.(4) The effect of NRR 20 mg on work tolerance lasted for 6 hr.These results suggest that NRR is effective for 6 hr and that more than 42% of thepeak plasma ISDN concentration remains for 8 hr after a single oral dosing.

The plasma concentration of a sustained-release isosorbide dinitrate(NRR) and exercise tolerance in patients with angina pectoris.