Clinical and hemodynamic effects of the new dilator drug molsidomine

The effects of a single 2 mg oral dose of molsidomine were assessed with treadmill multistage exercise testing in six men with stable angina. A double-blind, placebo-controlled protocol was used, with exercise to the point when anginal pain forced the patient to stop. Exercise was undertaken before and at 1/2, 1 1/2, 4, and 6 hours after drug administration. Molsidomine improved exercise performance, with the best antianginal effect at 1 1/2 hours after administration, when the mean times to limiting angina were approximately 6 3/4 minutes with placebo and 11 1/2 minutes with molsidomine (p less than 0.05). The corresponding energy expenditures were 33.8 and 77.6 mets, an increase of 130% with the active drug. Intra-arterial blood pressure recording verified that molsidomine had a vasodilator hemodynamic profile, and the immediate postexercise rate-pressure product 1 1/2 hours after molsidomine treatment was 232 mm Hg/min X 10(-2), compared with 183 mm Hg/min X 10(-2) after administration of placebo (NS). Side effects of molsidomine were limited to headache in two patients.