Skip to main content
Log in

24-hour anti-ischaemic action with once daily nifedipine

Experience obtained with a fatty-alcohol matrix tablet in patients with coronary artery disease

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

The ability of a fatty-alcohol matrix, slow-release tablet of nifedipine 60 mg to maintain a 24-hour antiischaemic action in the fixed dose of 60 mg once daily has been investigated in a randomised, placebo-controlled, double-blind trial.

12 normotensive patients with angiographically proven coronary artery disease (stenosis of at least one major vessel ≥ 70%) were studied. The anti-ischaemic response was assessed over a period of 4 days as changes in the exercise-induced ST-segment depression 6 h and 24 h postdose, and ST segment changes in 24-h ambulatory ECGs.

A measurable anti-ischaemic response was observed in 8 of the 12 patients. Exercise-induced ST-segment depression 6 h after the administration of nifedipine was reduced by 30% compared to placebo, and there was still a measurable anti-ischaemic response 24-h post-dosing. Both responses were independent of changes in exercise blood pressure. In 7 patients with ischaemic episodes in the 24-h ECGs, nifedipine treatment had only a minor effect on the intensity and duration of ischaemia.

It is concluded that a significant anti-ischaemic effect lasting 24 h could be demonstrated using effort-induced ST-segment changes in patients with angiographically proven coronary heart disease, who were treated once daily with nifedipine 60 mg as a fatty-alcohol slow release tablet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Moskowitz RM, Piccini PA, Nacarelli GV, Zelis R (1979) Nifedipine therapy for stable angina pectoris: preliminary results of effects on angina frequency and treadmill exercise response. Am J Cardiol 44:811–816

    Google Scholar 

  2. Kleinbloesem CH, van Brummelen P, van de Linde JA, Voogd PJ, Breimer DD (1984) Nifedipine: Kinetics and dynamics in healthy subjects. Clin Pharmacol Ther 35:742–749

    Google Scholar 

  3. Vetrovec GW, Parker VE, Cole S, Procacci PM, Tabatznik B, Terry R (1987) Nifedipine gastrointestinal therapeutic system in stable angina pectoris. Am J Med 83 [Suppl 6B]: 24–29

    Google Scholar 

  4. Woodcock BG, Menke G, Fischer A, Köhne H, Rietbrock N (1988) Drug input rate from the GI-tract. Michaelis-Menten kinetics and the bioavailability of slow release verapamil and nifedipine. Drug Design Delivery 2: 298–309

    Google Scholar 

  5. Raftery EB, Brigden G, Woodcock BG (1990) 24-Stunden Blutdruckprofile eines langwirkenden Nifedipinpräparates unter Anwendung intraarterieller Blutdruckmessungen. In: Deutsche Liga zur Bekämpfung des Bluthochdrucks (ed) Abstracts der 3. Nationalen Blutdruck-Konferenz, Heidelberg, S 81

  6. Feris JV, McHenry PL, Morris SN (1978) Concepts and applications of treadmill exercise testing and the exercise electrocardiogram. Am Heart J 95: 102–114

    Google Scholar 

  7. Kaltenbach M, Klepzig H, Tschirdewahn B (1964) Die Kletterstufe, eine einfache Vorrichtung für exakt meβbare und reproduzierbare Belastungsuntersuchungen. Med Klin 59: 248–254

    Google Scholar 

  8. Thürmann P, Odenthal HJ, Reitbrock N (1991) Converting enzyme inhibition in coronary artery disease: A randomised placebo-controlled trial with benazepril. J Cardiovasc Pharmacol 17: 718–723

    Google Scholar 

  9. Nayler WG (1988) Calcium Antagonists. Academic Press, London San Diego, pp 177–192

    Google Scholar 

  10. Vetrovec GW (1989) Once-daily therapy for angina pectoris with nifedipine gastrointestinal therapeutic system. Am J Med 86 [Suppl 1A]: 29–32

    Google Scholar 

  11. Deanfield J, Wright C, Fox K (1983) Treatment of angina pectoris with nifedipine: importance of dose titration. Br Med J 286: 1467–1470

    Google Scholar 

  12. Bacracheva N, Thürmann P, Rietbrock N (1990) Dose adjustment of nifedipine in hypertensive patients. Eur J Clin Pharmacol 38: 17–20

    Google Scholar 

  13. Caitman BR, Wagniart P, Pasternac A, Brevers G, Scholl JM, Lam J, Methe M, Ferguson RJ, Bourassa MG (1984) Improved exercise tolerance after propranolol, diltiazem or nifedipine in angina pectoris: comparison at 1, 3 and 8 hours and correlation with plasma drug concentration. Am J Cardiol 53: 1–9

    Google Scholar 

  14. Ardissino D, De Servi S, Salerno JA, Specchia G, Prevital M, Mussini A, Bobba P (1983) Efficacy, duration and mechanism of action of nifedipine in stable exercise-induced angina pectoris. Eur Heart J 4: 873–881

    Google Scholar 

  15. Khurmi NS, Raftery EB (1988) Lack of diurnal variation in maximal symptom e-limited exercise test response in chronic stable angina. Am J Cardiol 61: 38–42

    Google Scholar 

  16. Mulcahy D, Keegan J, Crean P, Quyyumi A, Shapiro L, Wright C, Fox K (1988) Silent myocardial ischaemia in chronic stable angina: a study of its frequency and characteristics in 150 patients. Br Heart J 60: 417–423

    Google Scholar 

  17. Fox KM, Mulcahy DA (1990) Circadian variation of the total ischemic burden and influence byβ-blocking agents. J Cardiovase Pharmacol 16 [Suppl 5]: S100–104

    Google Scholar 

  18. Shell WE, Dobson D (1990) Dissociaton of exercise tolerance and total myocardial ischemic burden in chronic stable angina pectoris. Am J Cardiol 66: 42–48

    Google Scholar 

  19. von Arnim T (1987) Influence of isosorbide-5-mononitrate 20 mg, sustained-release 50 mg and sustained-release nifedipine 20 mg on ischaemic ST segment changes during holter monitoring. Cardiology 74 [Suppl 1]: 40–45

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Woodcock, B.G., Thürmann, P.A., Pfleiderer, S. et al. 24-hour anti-ischaemic action with once daily nifedipine. Eur J Clin Pharmacol 43, 587–590 (1992). https://doi.org/10.1007/BF02284955

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02284955

Key words

Navigation