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Related Experiment Videos

Mononitrates: defining the ideal long-acting nitrate

W H Frishman1, E Amsterdam, S P Glasser

  • 1Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.

Clinical Therapeutics
|March 1, 1994
PubMed
Summary

Nitrates, converted to nitric oxide, treat myocardial ischemia by improving oxygen supply. New isosorbide-5-mononitrate formulations offer options for chronic stable angina, though formulation differences warrant further study.

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Area of Science:

  • Cardiovascular Pharmacology
  • Vascular Biology

Background:

  • Nitric oxide (NO) and endothelial-derived relaxing factor (EDRF) are crucial for vascular control.
  • Dysfunction in EDRF signaling contributes to myocardial ischemia.
  • Nitrates offer a therapeutic strategy by replenishing NO.

Purpose of the Study:

  • To review the renewed interest in nitrates for ischemic syndromes.
  • To introduce new formulations of isosorbide-5-mononitrate.
  • To highlight potential differences between mononitrate formulations.

Main Methods:

  • Literature review on nitric oxide, EDRF, and nitrates.
  • Overview of recently available isosorbide-5-mononitrate formulations in the US.
  • Discussion of the implications of formulation variations.

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Main Results:

  • Nitrates, through conversion to nitric oxide, induce vasodilation.
  • This vasodilation improves the myocardial oxygen supply-demand balance, alleviating ischemia.
  • Three distinct isosorbide-5-mononitrate formulations (Ismo, Monoket, Imdur) have been introduced since 1992.

Conclusions:

  • Isosorbide-5-mononitrate represents a significant advancement in nitrate therapy.
  • Despite sharing a generic name, available mononitrate formulations differ.
  • Further research is needed to elucidate clinical distinctions between these formulations for optimal patient care.