High dose oral isosorbide dinitrate and ischemic heart pain: a preliminary report.
During the past two years, the author has treated 50 patients with angina pectoris, acute coronary insufficiency and acute myocardial infarction with high-dose oral isosorbide dinitrate. The daily dosage used varied between 120 and 360 mg daily, in contrast to the very small doses (10 mg tid and hs), usually recommended by the manufacturer and by many physicians. Previous articles in the literature suggest that oral isosorbide dinitrate is not effective in the prophylaxis of anginal pain. However, there are strong differences of opinion on this point, and our experience suggests that the lack of effect has been the result of the small dosage recommended.A double-blind cross-over study with placebo control and objective measurements of the degree of myocardial ischemia, is under way and will be reported in due course.
Shane
S J
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