Nitrate therapy: is there an optimal substance and formulation?
Nitrate therapy has been shown to be beneficial for the treatment of coronary artery diseases and a number of chemical entities and their respective pharmaceutical formulations are available for clinical use. In this report, the performance of these nitrate drug/formulation combinations is discussed in terms of the relative onset of action, duration of action, tolerance properties/regeneration of reactivity and patient acceptance. A pharmacodynamic action scheme is presented and this allows a systematic assessment of how changes in the nitrate and/or formulation may impact on therapeutic activity. Data suggest that several sustained-release preparations of various nitrates can provide protection against exercise-induced angina for about 12 h on repeated dosing, provided a 'nitrate-free' or 'nitrate-poor' interval is also instituted. The 'ideal' nitrate substance and formulation, which theoretically can provide around-the-clock protection, is not yet available.
Fung
H L
HL
Department of Pharmaceutics, School of Pharmacy, State University of New York, Buffalo 14260.
D000787:Angina Pectoris / Q000188:drug therapy*; D002626:Chemistry, Pharmaceutical; D003258:Consumer Behavior; D003692:Delayed-Action Preparations; D006801:Humans; D009566:Nitrates / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D009566:Nitrates