Buccal versus sublingual glyceryl trinitrate administration in the treatment of angina pectoris. A Swedish multicentre study.
126 patients with chronic exercise-induced angina, who were accustomed to the use of sublingual glyceryl trinitrate, were entered into a multicentre 2-week crossover comparison of sublingual (Nitromex) and buccal (Suscard) formulations of glyceryl trinitrate. Before randomisation the patients underwent a training period when doses of the buccal formulation were individualised. There were 31% fewer attacks with the buccal formulation, and more patients reported higher physical activity on the buccal compared with the sublingual formulation (30% vs 16%). The buccal formulation was also more effective when glyceryl trinitrate was used prophylactically to prevent expected attacks, being effective in 74% of attempts compared with 66% for the sublingual formulation (p less than 0.05). More patients preferred the buccal route of administration for prophylactic use (81% vs 4%, p less than 0.05). Similarly, when asked to select which they would use in future, 65% of patients preferred the buccal formulations (p less than 0.05), 19% preferred sublingual glyceryl trinitrate, and 16% did not express any preference.
D000208:Acute Disease; D000284:Administration, Oral; D000787:Angina Pectoris / Q000188:drug therapy* / Q000517:prevention & control; D002986:Clinical Trials as Topic; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011897:Random Allocation; D013548:Sweden
D005996:Nitroglycerin