Interval Treatment of Congestive Heart Failure with Once-Daily Administration of 120 mg Isosorbide Dinitrate in Sustained-Release Form: No Evidence of Tolerance Development During Long-term Therapy
Nitrate compounds, such as isosorbide dinitrate (ISDN), are useful agents with which acutely, elevated ventricular filling pressures can be lowered [3–5]. Since they are inexpensive, easy to use, and without serious side effects, their use for long-term treatment of congestive heart failure has gained wide acceptance without their actual efficacy having been conclusively proved. In studies performed on our service, similar to the response observed on continuous administration for treatment of angina pectoris, in patients with congestive heart failure, we found that the marked lowering of pulmonary artery pressure seen on the 1st day of treatment with 40 mg ISDN four times daily was already diminished after 3–4 days and completely attenuated by the 7th day of treatment [1, 2]. After a 1-day nitrate-free interval, on the 9th day of hemodynamic monitoring, renewed administration of the drug was met with full restitution of the effects, comparable to those seen after acute administration.
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