Which of the following drug can be used for prophylaxis as well as for the treatment of angina?
High-Yield Explanation
Isosorbide dinitrate can be used for prophylaxis as well as for the treatment of angina pectoris.
Isosorbide dinitrate: It is a solid but similar in properties to GTN; can be used sublingually at the time of attack (slightly slower in action than GTN, peak in 5-8 min) as well as orally for chronic prophylaxis. Presystemic metabolism on oral administration is pronounced and variable. The t½ is 40 min, but sustained release formulation may afford protection for 6-10 hours. Last dose should not be taken later than 6 PM to allow nitrate level to fall during sleep at night.
Administration of isosorbide mononitrate:
(typically starting at 20 mg) Once or twice daily (in the latter case, with the doses administered 7 hours apart) is efficacious in the treatment of chronic angina, and once-daily dosing or an eccentric twice-daily dosing schedule can minimize the development of tolerance.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 589,590