Molsidomine, an effective long-acting anti-anginal drug

Molsidomine was compared with propranolol for anti-anginal efficacy in a double-blind, cross-over, fixed-dose clinical trial, involving 39 patients with moderate, stable angina pectoris, and objective evidence of coronary sclerosis. The incidence of anginal attacks under molsidomine did not differ statistically from that under propranolol. However, propranolol was more effective in reducing the nitroglycerin requirement at the doses used. Ergometry showed that both drugs increased exercise tolerance to a comparable extent. However the rate pressure product during exertion indicates that these drugs achieve this result via different paths, molsidomine having a nitrate-like effect. Unwanted effects during the four week treatment periods were minor and generally tolerable. Molsidomine is an effective long-acting anti-anginal agent with nitrate-like effects and should be a useful addition to the drugs already in use.