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Related Experiment Videos

Eccentric dosing with isosorbide-5-mononitrate in angina pectoris

J O Parker1

  • 1Department of Medicine, Queen's University, Kingston General Hospital, Ontario, Canada.

The American Journal of Cardiology
|October 15, 1993
PubMed
Summary

Immediate-release isosorbide-5-mononitrate (IS-5-MN) effectively improved exercise duration and reduced angina episodes in stable angina patients. Eccentric dosing did not lead to tolerance or rebound effects during the 3-week study.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Stable angina remains a significant cardiovascular condition requiring effective management.
  • Isosorbide-5-mononitrate (IS-5-MN) is a nitrate vasodilator used for angina treatment.
  • Understanding the efficacy and tolerance of immediate-release IS-5-MN with specific dosing regimens is crucial.

Purpose of the Study:

  • To evaluate the efficacy of immediate-release isosorbide-5-mononitrate (IS-5-MN) in patients with stable angina.
  • To assess the development of tolerance and potential rebound effects with eccentric dosing of IS-5-MN.
  • To determine the optimal dosage and timing for IS-5-MN administration in managing angina.

Main Methods:

  • A placebo-controlled, parallel, double-blind study involving 214 patients with stable angina.

Related Experiment Videos

  • Administration of IS-5-MN (5, 10, 20 mg) or placebo twice daily (0800 and 1500 hours) for 3 weeks.
  • Exercise testing performed at various time points post-dosing on specific study days to measure exercise duration and time to angina.

    • Main Results:

    • Active IS-5-MN treatment groups demonstrated significant improvements in exercise duration and time to angina compared to placebo.
    • The 20 mg dose of IS-5-MN was most effective, reducing angina episodes and improving exercise duration, even 7 hours post-dose.
    • No significant nocturnal angina increase or tolerance development was observed with eccentric dosing, and no rebound effect was detected.

    Conclusions:

    • Immediate-release IS-5-MN is an effective treatment for stable angina, improving exercise capacity and reducing angina symptoms.
    • Eccentric dosing (0800 and 1500 hours) of IS-5-MN does not lead to tolerance or rebound phenomena.
    • The 20 mg dose of IS-5-MN shows superior efficacy, supporting its use in angina management.