According to Medscape , for immediate release ISMN, given in 2 doses, on awakening and 7 hours later each day has been shown to prevent development of tolerance without inducing clinical rebound in a well-designed clinical trial. Waller , for once daily formulations of ISMN, it delivers high plasma nitrate concentrations that improve exercise tolerance in patients with angina for at least 12 h after dosing.
During the remainder of the dosage interval, plasma nitrate concentrations fall but are sufficient to protect against coronary artery spasm overnight. The pharmacokinetic profile of this formulation prevents the development of tolerance, while also conferring long-term anti-anginal efficacy.
Another consideration in the selection of an isosorbide regimen is patient adherence. Thadani U. Nitrate therapy and the development of tolerance.
Arch Fam Med. Labels: general , Indication , pharmacokinetics. No comments:. Post a Comment Note: Only a member of this blog may post a comment. Newer Post Older Post Home. Subscribe to: Post Comments Atom. In contrast, systolic blood pressure decreased very significantly in all groups p less than 0.
Diastolic blood pressure also decreased in all groups but only to a highly significant degree in patients treated with isosorbidemononitrate p less than 0. In patients treated with isosorbide dinitrate retard, the reduction in diastolic pressure was only statistically significant when the patients in the group were considered as a whole p less than 0.
The most frequent side-effect was headache, which improved gradually. During treatment there was a progressive dissociation between reduction in the intensity and frequency of this adverse effect and the increasing anti-anginal action of the nitrates.
Abstract A multi-centre study was carried out in coronary patients to compare the efficacy and tolerance of isosorbide dinitrate retard 40 mg and isosorbidemononitrate 20 mg with regard to the frequency of anginal attacks and consumption of sub-lingual short acting nitrates.
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