Efficacy of sustained-release buccal nitroglycerin in patients with angina pectoris. New and long-acting therapy demonstrated by exercise.
The antianginal efficacy of a single sustained-release buccal nitroglycerin (BNTG) tablet was assessed in 16 patients with known coronary artery disease. Patients were trained in bicycle ergometry to induce angina pectoris within three to five minutes. A hemodynamically effective dose of BNTG was identified. Patients were tested at baseline and given placebo and BNTG in a randomized, double-blind manner on consecutive days. They were tested at 0.5, 1, 3, and 5 hours after drug administration. The average increase in exercise duration with BNTG compared with placebo at 0.5 hours was 40 percent (p less than 0.01); at 1 hour was 31 percent (p less than 0.01); at 3 hours was 27 percent (p less than 0.01); at 5 hours was 15 percent (p = NS). In a subset of ten patients in whom the tablet was maintained in the buccal pouch for five or more hours before dissolving, increase in exercise duration was significant at all times tested (p less than 0.05). We conclude that BNTG is an effective modality of administering nitroglycerin for rapid and prolonged effect with reduction in angina pectoris and increase in exercise duration which may persist for at least five hours.
D000328:Adult; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D002610:Cheek; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism; D005996:Nitroglycerin / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D011897:Random Allocation
D003692:Delayed-Action Preparations; D005996:Nitroglycerin