[Effect duration and dose-response relation of molsidomine in patients with coronary heart disease].

The dose-effect relation and duration of action of 2 mg, 4 mg and 6 mg molsidomine on ischemic ST-segment depression in the exercise-ECG were determined in a randomized and double-blind acute study of 12 patients with confirmed coronary artery disease. With 2 mg molsidomine a significant reduction in the amount of ischemic ST-depression from 18.0 mm to 8.1 mm, 45% of the baseline-figure, resulted. With 6 mg molsidomine a diminuation of the ST-segment depression from 16.2 mm to 6 mm, approximately 40%, was noted. The significant antianginal effect of 2 mg molsidomine lasted at least 3 hours. After 5 hours an effect was seen only in some patients. 4 mg and 6 mg molsidomine still showed a significant reduction of ST-segment depression after 5 hours. A sufficient antianginal efect over 24 hours is only achieved with a 2-mg dose administered 5-6 times or with a 4-6 mg dose applied 4-5 times daily. The most marked fall in blood pressure was noticed after 6 mg molsidomine. On average, the systolic blood pressure fell 41 mm Hg (22%). Orthostatic reactions were not seen. The maximal dose-dependent plasma levels were 15.8 ng/ml, 30.1 ng/ml and 50.0 ng/ml. A definite, reliable clinical effect was seen in some cases from plasma levels above 2 ng/ml.