An assessment of single doses of 8 mg sustained-release molsidomine using serial exercise tests

In 16 patients with documented coronary artery disease, the extent and duration of acute antiischemic and hemodynamic effects of monotherapies with 120 mg of sustained-release isosorbide dinitrate once daily and 8 mg of sustained-release molsidomine 3 times daily were compared according to a randomized, double-blind, cross-over and placebo-controlled protocol including exercise testing for assessment of ST-segment depression (ST) at an identical workload and determination of plasma concentrations of both substances. Up to 8 h after dosing in the morning, more marked and sustained effects were observed with the nitrate (ST at 2 h, -82%; p < 0.001; at 8 h, -64%; p < 0.01) than with molsidomine (2 h, -68%; p < 0.001; at 8 h, -9%; NS). At 12 h, no more meaningful actions were detectable with isosorbide dinitrate (-13%, NS) despite plasma concentrations still within a range otherwise considered therapeutically effective, whereas with molsidomine, at 4 h after renewed dosing, this parameter was reduced by 38% (p < 0.01). However, therapeutic coverage over a 24-h period could be demonstrated on neither regimen, in the case of the nitrate because of the development of early tolerance, and in the case of molsidomine with its meaningfully shorter half-life because of the necessity of increasing the dosing frequency even further. No meaningful adverse effects were observed with either regimen. Nonresponders, overall a minority on one treatment, responded completely to the alternative regimen and vice versa.

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Clinical Comparison of Antiischemic Efficacy of Isosorbide Dinitrate and Molsidomine

Lehmann

Reiniger

Beyerle

et al. 1998

Journal of Cardiovascular Pharmacology

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The Effects of Oral Nitric Oxide Donor (Molsidomine) in Patients with Variant Angina Unresponsive to Conventional Anti-Anginal Drugs

Cho¹,

Jeong²,

Park³

et al. 1998

Korean Circ J

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BackgroundWe observed the changes of clinical characteristics after oral Molsidomine, a nitric oxide donor, in patients who have documented coronary artery spasm by ergonovine coronary angiogram and refractory to conventional anti-anginal therapy. Method Molsidomine, oral nitric oxide donor, was administrated over 12 weeks in 20 patients 6 male, 14 female, 54 11.5 years in order to observe the clinical effects in patients with coronary artery spasm unresponsive to nitrate and calcium channel blockers. Changes in the frequency of pain and sublingual nitroglycerin use, blood pressure, heart rate, side effects, electrocardiogram, and laboratory findings were evaluated before and after Molsidomine therapy. Results The frequencies of pain and sublingual nitroglycerin use were 3.9 0.9/week before treatment and decreased to 2.9 0.9/week at 4th week after the additional Molsidomine treatment pre-treatment vs. 4th week p 0.001 , to 1.0 0.8/week at 8th week 4th week vs. 8th week p 0.001 , and to 0.7 0.8/week at 12th week. Systolic blood pressure decreased after treatment, but there were no significant changes in diastolic blood pressure, heart rate, resting electrocardiogram and laboratory findings. Molsidomine was discontinued in one patient because of headache. Conclusions Molsidomine is an effective and well tolerated anti-ischemic agent in patients with variant angina refractory to conventional anti-anginal therapy. Korean Circulation J 1998 ; 28 9 : 1577-1582

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An assessment of single doses of 8 mg sustained-release molsidomine using serial exercise tests

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Clinical Comparison of Antiischemic Efficacy of Isosorbide Dinitrate and Molsidomine

Clinical Comparison of Antiischemic Efficacy of Isosorbide Dinitrate and Molsidomine

The Effects of Oral Nitric Oxide Donor (Molsidomine) in Patients with Variant Angina Unresponsive to Conventional Anti-Anginal Drugs

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