Research Article

Assessment of dermal glyceryl trinitrate and isosorbide dinitrate for patients with angina pectoris.

Br Med J (Clin Res Ed) 1985; 290 doi: https://doi.org/10.1136/bmj.290.6467.514 (Published 16 February 1985) Cite this as: Br Med J (Clin Res Ed) 1985;290:514
  1. P J Hubner,
  2. P R Jones,
  3. I A Galer

    Abstract

    Dermal nitrate preparations are claimed to be useful in the treatment of angina, as their slow absorption by-passing the liver leads to a sustained action. Ten patients with angina were exercised on a treadmill after dermal application of 16.64 mg glyceryl trinitrate or 100 mg isosorbide dinitrate or placebo. Exercise duration was significantly increased at one and three hours for both nitrate preparations but not at six hours after application. The calculated workload achieved was significantly increased (p less than 0.01) at one and three hours for both preparations and at six hours (p less than 0.05) for isosorbide dinitrate. Headaches were common with glyceryl trinitrate cream. The dermal nitrate preparations studied had a duration of antianginal action similar to that of oral nitrate tablets. Aside from their value when the oral route cannot be used or absorption may be delayed, dermal nitrate preparations have no advantage over oral preparations for angina pectoris.