[Molsidomine in chronic heart failure with liver congestion--oral or intravenous therapy?].

Patients suffering from congestive heart failure combined with gastrointestinal congestion often present irregular resorption and metabolism of orally applicated cardiovascular drugs. Intravenous therapy therefore is used very often for those patients. In this trial we compared the efficiency of molsidomine given either orally or intravenously in patients suffering from congestive heart failure. We investigated ten patients (54.6 +/- 13 years) with congestive heart failure (NYHA III and IV) and a central venous pressure > 10 mmHg. Five patients of group A were given 4 mg of molsidomine intravenously on the first day and an oral dose of 4 mg of molsidomine on the second day. The five patients of group B received the oral dose on the first day and intravenous treatment on the second day. Central venous pressure and plasma levels of molsidomine and of the effective metabolite SIN-1 were measured before as well as ten, 20, 40, 60 minutes, two, four and eight hours after application of molsidomine. Central venous pressure decreased significantly up to two hours after molsidomine in both oral and intravenous groups (p < or = 0.01). There was no relevant difference between the oral and the intravenous group. The hemodynamic parameters correlated with molsidomine plasma levels. According to our results the efficiency of oral molsidomine does not differ from intravenous molsidomine in patients with congestive heart failure.