Mononitrates pp 188-189 | Cite as

Slow-Release Isosorbide-5-Mononitrate for the Treatment of Angina Pectoris: Duration of Effects

  • U. Thadani
  • S. Hamilton
  • S. Teague
  • D. Brady
  • B. White
Part of the International Boehringer Mannheim Symposia book series (BOEHRINGER)


Isosorbide dinitrate (ISDN) is widely used for the treatment of angina pectoris and has been shown to prolong exercise tolerance during acute and sustained therapy [1–8]. However, ISDN is poorly bioavailable after oral intake, and a marked inter-individual variation in plasma ISDN concentrations has been reported after oral doses during both acute and chronic therapy [4]. After oral ingestion, ISDN is rapidly metabolized into 2- and 5-mononitrates, both of which are biologically active. Now commercially available in Europe, isosorbide-5-mononitrate (IS-5-MN) has a half-life of 4–6 h and is almost 100% bioavailable after oral ingestion [9]. The latter makes this compound pharmacokinetically more desirable than its parent compound ISDN. Furthermore, a slow-release formulation of IS-5-MN providing high plasma levels for up to 24 h is now available which should theoretically offer advantages by exerting antianginal effects over a prolonged period of time.


Angina Pectoris High Plasma Level Isosorbide Dinitrate Antianginal Effect Antianginal Efficacy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Glancy DL, Ritcher MA, Ellis EV, Johnson W (1977) Effect of swallowed isosorbide dinitrate on blood pressure, heart rate, and exercise capacity in patients with coronary artery disease. Am J Med 62:39PubMedCrossRefGoogle Scholar
  2. 2.
    Danahy DT, Aronow WS (1977) Hemodynamic and antianginal effects of high-dose oral isosorbide dinitrate after chronic use. Circulation 56:205PubMedGoogle Scholar
  3. 3.
    Danahy DT, Burwell DT, Aronow WS, Prakash R (1977) Sustained hemodynamic and antianginal effects of high oral dose isosorbide dinitrate. Circulation 55:381PubMedGoogle Scholar
  4. 4.
    Thadani U, Fung H-L, Darke AC, Parker JO (1982) Oral isosorbide dinitrate in angina pectoris: comparison of duration of action and dose response relationship during acute and sustained therapy. Am J Cardiol 219:411CrossRefGoogle Scholar
  5. 5.
    Thadani U (1984) Nitrates for angina pectoris: a critical review of therapeutic efficacy and tolerance. Herz 9:123PubMedGoogle Scholar
  6. 6.
    Lee G, Mason DT, Amsterdam EA, Miller RR, Demaria AM (1978) Antianginal efficacy of oral therapy with isosorbide dinitrate capsules: prolonged benefit shown by exercise testing in patients with ischemic heart disease. Chest 73:327PubMedCrossRefGoogle Scholar
  7. 7.
    Rudolph W, Blasini R, Froer KL, Brügmann U, Mannes A, Hall D (1981) Effects of acute and chronic administration of isosorbide dinitrate, sustained-release form, in patients with angina pectoris. In: Lichtlen PR, Engel H-J, Schrey A, Swan HJC (eds) Nitrates III. Springer, Berlin Heidelberg New York, p 75CrossRefGoogle Scholar
  8. 8.
    Schneider W, Wietschoreck, Bussmann WD, Kaltenbach M (1983) Sustained antianginal efficacy of high-dose isosorbide dinitrate in patients with coronary heart disease. Z Kardiol 72 [Suppl 3]:259PubMedGoogle Scholar
  9. 9.
    Chasseaud LF, Taylor T (1981) Pharmacokinetics of isosorbide-5-mononitrate. In: Kaltenbach, Bussmann, Schrey (eds) Mononitrate workshop. Wolf, Munich, p 12Google Scholar
  10. 10.
    Thadani U, Hamilton S, Teague S, Brady D, White B (to be published) Circulatory and antianginal effects of isosorbide-5-mononitrate: slow-release formulation in angina pectoris.Google Scholar
  11. 11.
    Parker JO, Vankoughnett KA, Fung H-L (1984) Transdermal isosorbide dinitrate in angina pectoris: effects of acute and sustained therapy. Am J Cardiol 54:8PubMedCrossRefGoogle Scholar
  12. 12.
    Tauchert M, Jansen W, Osterspey A, Fuchs M, Hombach V, Hilger HH (1983) Dose dependence of tolerance during treatment with mononitrates. Z Kardiol 72 [Suppl 3]:218PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • U. Thadani
  • S. Hamilton
  • S. Teague
  • D. Brady
  • B. White

There are no affiliations available

Personalised recommendations