Nisoldipine CC: clinical experience in ischaemic heart disease

Nisoldipine coat core (CC) is a long-acting calcium channel blocker (CCB) with a slow and smooth onset of action. It is effective in the treatment of angina pectoris, increasing exercise duration, time to ST segment depression and time to onset of angina. The results of two studies reviewed here, in which patients received concomitant treatment with a beta-blocker, showed that the anti-anginal efficacy of nisoldipine CC, 40 mg once daily, measured at trough was comparable with amlodipine, 10 mg once daily, and with diltiazem retard, 120 mg twice daily, and that efficacy was maintained over a 24-hour period. The third trial reviewed here showed that nisoldipine CC was at least as effective as three-times-daily treatment with diltiazem (total dose 240 mg). To date, the effects of nisoldipine CC have been investigated in over 4,000 patients with hypertension and angina pectoris. Clinical experience suggests that once-daily nisoldipine CC is at least as well tolerated as other CCBs, provides consistent efficacy and is a useful treatment in the management of patients with angina pectoris. The CCBs show promising beneficial effects in experimental atherosclerosis and a small number of clinical trials show some effect on the progression of atherosclerosis in coronary artery disease and restenosis following coronary angioplasty. An ongoing long-term trial with nisoldipine CC after coronary angioplasty is discussed.