The deficit of endogenous nitric oxide (NO) which leads to endothelial dysfunction is the cornerstone of the pathogenesis and plays an important role in the evolution of cardiovascular diseases. The basic medications used for NO supplementation are the organic nitrates. They have high anti-anginal and anti-ischemic effectiveness but possess various adverse effects. A major disadvantage of their application is the development of drug tolerance. It may be overcome by prescribing medications with a nitrate-like effect, among which is molsidomine - a direct donor of NO. The effectiveness of molsidomine is tested and proven in various clinical trials, mostly in patients with stable ischemic heart disease and after percutaneous coronary interventions. The clinical experience after its application shows excellent results and very good tolerability.
Napoli C, Ignarro LJ. Nitric oxide-releasing drugs. Annu Rev Pharmacol Toxicol. 2003;43:97–123.
Nossaman VE, Nossaman BD, Kadowitz PJ, Nitrates and nitrites in the treatment of ischemic cardiac disease, Cardiol Rev. 2010;18(4):190-7.
Abrams J. Glyceryl trinitrate (nitroglycerin) and the organic nitrates. Choosing the method of administration. Drugs. 1987;34:391–403.
Braunwald’s Heart Disease. Stable Ischemic Heart Disease. A textbook of Cardiovascular Medicine, 9th edition. Elsevier. Saunders. 2012.
Messin, R.et al. Efficacy and safety of molsidomine once-a-day in patients with stable angina pectoris.- Int. J. Cardiol. 2005; 98:79-89.
Arkonac BM et al., Differential Hemodynamic Effects of the Nitric Oxide Donor Pirsidomine in Comparison to SIN-1, Nitroprusside and Nitroglycerin, Pharmacology. 1996: 52(2): 92-100.
Darius H, Ahland B, Rucker W, Klaus W, Peskar BA, Schror K. The effects of molsidomine and its metabolite SIN–1 on coronary vessel tone, platelet aggregation, and eicosanoid formation in vitro: Inhibition of 12–HPETE biosynthesis. J Cardiovasc Pharmacol. 1984; 6:115–121.
Lablanche J. et al. ACCORD Study. Circulation., 95, 1997, № 1, 83-89
Vertkin AL, Topolyanskyi AW. Molsidomine – new perspectives. Russian Med J. 2005; 7:430. (in Russian)
