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Nifedipine monothempy may be superior to isosorbide dinitrate monotherapy For angina, with no admntage of combination therapy seen

For patients with stable angina pectoris " , , who cannot tolerate /i-blockers, nifedipine alone maJ' be sllperior to isosorbide dinitrate alone, The conbination of nifedipine and isosorbide dinitrate prodllced no major adl'antage', 18 patients with chronic stable angina received isosorbide dinitrate for a 2-week baseline period then were randomised to receive isosorbide dinitrate 40-120 mg/day. nifedipine 40-120 mg/day or isosorbide dinitrate + nifedipine for 3 weeks each in a double-blind crossover fashion; 12 patients were evaluable.

Nifedipine monotherapy resulted in significantly fewer episodes of angina than isosorbide dinitrate monotherapy but there was no significant difTerence in the number of episodes between combination therapy and isosorbide dinitrate monotherapy. Compared with isosorbidc monothcrapy. the tillie to angina onset during exercise was significantly longer with nifedipine monotherapy and combination therapy; the increase was greatest with nifedipine monotherapy. Nifedipine monotherapy significantly reduced the maximum ST depression during and after exercise compared with isosorbide dinitrate monotherapy. Diastolic BP was significantly decreased by combination therapy compared with isosorbide monotherapy. Mild adverse effects such as headache and ankle oedema occurred in 7 patients which resolved with dosage adjustments.

Vlay sc. Olson l.C . Nifcdipine and isosorbide dinitratc alone and in Clllllbinaliull for paticnb with chroniC stable angina: a duuble-blind l'rOSSO\Tr stlldy. ·\mrrican Heart Journal I ~O; 303-307. Aug 1'1'10 ."."

15 Sep 1990 INPIIARMA® ISSN 0156-2703/90/0915-0016/0$01.00/0 Ii) Adis International Ltd