Hemodynamic effects of cutaneously administered isosorbide dinitrate ointment

With a view to testing the hemodynamic effects of a 10% isosorbide dinitrate ointment, about 40 mg of the drug was applied to the skin of nine cardiologically healthy volunteers. The ensuing hemodynamic changes were followed up for six hours by means of noninvasive techniques including echocardiography. As early as 30 min after drug application, significant decreases in heart rate, cardiac output, systolic blood pressure and intracardiac diameters were recorded. Only systolic blood pressure had returned to initial values by the end of the observation period. Isosorbide dinitrate ointment diminished myocardial oxygen consumption for a duration beyond six hr, by reducing pressure and heart-rate work of the left ventricle.