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Comparison of the Effect of Isosorbide‐5‐Mononitrate and Isosorbide Dinitrate in a Slow‐Release Form on Exercise‐Induced Myocardial Ischemia
Author(s) -
Hennig Lars,
Andresen Dietrich,
Hennig Ameneh,
Levenson Benny,
Brüggemann Thomas,
Schroder Rolf
Publication year - 1991
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1991.tb03749.x
Subject(s) - isosorbide dinitrate , isosorbide , isosorbide mononitrate , medicine , crossover study , placebo , anesthesia , angina , pharmacology , cardiology , chemistry , myocardial infarction , alternative medicine , organic chemistry , pathology
A randomized, double blind, placebo‐controlled crossover study on 20 patients with exercise‐induced angina pectoris and reproducible ST‐segment depression during exercise‐stress test was performed to compare the effect of a single dose of 120 mg of isosorbide dinitrate in a slow‐release form with that of a twice‐daily application of 20 mg of isosorbide‐5‐mononitrate. Symptom‐limited exercise tests were done, and nitrate plasma levels were measured in the subjects 6, 10, and 24 hours after the first administration of the drug. Both drugs produced a highly significant reduction in the size of exercise‐induced ST‐depressions ( P < .001) 6 and 10 hours after the first administration of isosorbide dinitrate as well as 6 hours after the first and 4 hours after the second dose of isosorbide‐5‐mononitrate. The effect was still significant ( P < .05) 24 hours after the administration of isosorbide dinitrate in a slow‐release form and 18 hours after the second dose of isosorbide‐5‐mononitrate. In the case of the drug isosorbide dinitrate, nitrate plasma levels for its metabolite, isosorbide‐5‐mononitrate, were highest 10 hours after first application. In the case of the drug isosorbide‐5‐mononitrate, nitrate plasma levels were highest 4 hours after the second dose. Two 20 mg doses of isosorbide‐5‐mononitrate and a single dose of 120 mg isosorbide dinitrate in a slow release form have a comparable effect on the reduction of exercise‐induced ST‐segment depressions .