Ninety-seven elderly patients with stable angina were included in a 28-week, randomized, double-blind, parallel-group comparison of amlodipine 5–10 mg and isosorbide mononitrate 25–50 mg once daily. The total exercise time, as limited by angina, was recorded together with the median incidence per week of angina attacks and glyceryl trinitrate consumption. Safety was assessed by adverse event frequency, measurement of vital signs and laboratory parameters, and quality of life. At the final visit, the total exercise time was significantly greater relative to baseline with amlodipine than isosorbide mononitrate (final/baseline difference: 112.2 vs. 32.2, p = 0.016). There were no statistically significant differences between the groups in relation to the incidence of adverse events. Once daily amlodipine provides significantly better control of stable angina than isosorbide mononitrate in this elderly population.

1.
Asirvatham S, Sebastian C, Thadani U: Choosing the most appropriate treatment for stable angina: Safety considerations. Drug Safety 1998;19:23–44.
2.
Perondi R, Saino A, Zanchetti A: Coronary vascular reactivity and calcium antagonist therapy in patients with angina. J Cardiovasc Pharmacol 1994;24(suppl A):S30–S36.
3.
van Kesteren HAM, Withagen AJAM, on behalf of the Amlodipine Study Group: A comparative study of once-daily amlodipine versus twice-daily diltiazem controlled release (CR) in the treatment of stable angina pectoris. Cardiovasc Drugs Ther 1998;12:233–237.
4.
Abernethy DR: The pharmacokinetic profile of amlodipine. Am Heart J 1989;118:1100–1103.
5.
Deedwania PC, Cheitlin MD, Das SK, Pool PE, Singh JB, Pasternak RC: Amlodipine once a day in stable angina: Double-blind crossover comparison with placebo. Clin Cardiol 1993;16:599–602.
6.
Vertrovec GW, Dailey S, Kay G, et al: Haemodynamic and electrophysiological effects of amlodipine, a new long-acting calcium antagonist. Postgrad Med J 1991;67(suppl 5):S60–S61.
7.
Frais MA, Silke B, Verma SP, Sharma SK, Reynolds G, Jackson NC, Taylor SH: A haemodynamic dose finding study with a new slow-calcium channel blocker (amlodipine) in coronary artery disease. Herz 1986;11:351–358.
8.
Glasser SP, West PW: Clinical safety and efficacy of once daily amlodipine for chronic stable angina pectoris. Am Heart J 1989;115:1127–1128.
9.
Taylor SH: The efficacy of amlodipine in myocardial ischemia. Am Heart J 1989;118:1123–1126.
10.
Taylor SH: A review of amlodipine in myocardial ischaemia. Postgrad Med J 1991;67(suppl 5):S48–S51.
11.
Cocco G, Alfiero R: A double-blind dose-response study of amlodipine in patients with stable angina pectoris. Eur Heart J 1991;12:169–174.
12.
Detry J-MR: Amlodipine and the total ischemic burden: Circadian Anti-Ischemia Program in Europe (CAPE) trial – Methodology, safety and toleration. Cardiology 1994;85 (suppl 2):24–30.
13.
Ezekowitz MD, Hossack K, Mehta JL, Thadani U, Weidler DJ, Kostuk W, Awan N, Grossman W, Bommer W: Amlodipine in chronic stable angina: Results of a multicenter double-blind crossover trial. Am Heart J 1995;129:527–535.
14.
Watanabe K, Ochiai Y, Washizuka T, Inomata T, Miyakita Y, Shiba M, Izumi T, Shibata A, Qu YL, Nagatomo T: Clinical evaluation of serum amlodipine level in patients with angina pectoris. Gen Pharmacol 1996;27:205–209.
15.
Deedwania PC: Anti-ischemic effects of amlodipine in patients with stable angina pectoris and myocardial ischemia during daily life. Amlodipine Study Group. Am J Cardiol 1999;83:1117–1119.
16.
Midtbo K, Molstad P: Amlodipine versus slow release metoprolol in the treatment of stable exertional angina pectoris (AMSA). Scand Cardiovasc J 2000;34:475–479.
17.
Pehrsson SK, Ringqvist I, Ekdahl S, Karlson BW, Ulvenstam G, Persson S: Monotherapy with amlodipine or atenolol versus their combination in stable angina pectoris. Clin Cardiol 2000;23:763–770.
18.
Jollis JG, Simpson RJ, Chowdhury MK, Cascio WE, Crouse JR 3rd, Massing MW, Smith SC Jr: Calcium channel blockers and mortality in elderly patients with myocardial infarction. Arch Intern Med 1999;159:2341–2348.
19.
Tzivoni D, Kadr H, Braat S, Rutsch W, Ramires JA, Kobrin I: Efficacy of mibefradil compared with amlodipine in suppressing exercise-induced and daily silent ischemia. Circulation 1997;96:2557–2564.
20.
Davies RF, Habibi H, Klinke WP, Dessain P, Nadeau C, Phaneuf DC, Lepage S, Raman S, Herbert M, Foris K: Effect of amlodipine, atenolol and their combination on myocardial ischemia during treadmill exercise and ambulatory monitoring. J Am Coll Cardiol 1995;25:619–625.
21.
van der Vring JA, Daniels MC, Holwerda NJ, Withagen PJ, Schelling A, Cleophas TJ, Hendriks MG: Combination of calcium channel blockers and β-adrenoceptor blockers for patients with exercise-induced angina pectoris: A double-blind parallel-group comparison of different classes of calcium channel blockers. Br J Clin Pharmacol 1999;47:493–498.
22.
Cleophas TJ, Van der Sluijs J, Van der Vring JA, Daniels MC, Holwerda KJ, Withagen AJ, Schelling A, Hendriks MG, Zwinderman AH: Combination of calcium channel blockers and beta-blockers for patients with exercise-induced angina pectoris: Beneficial effect of calcium channel blockers largely determined by their effect on heart rate. J Clin Pharmacol 1999;39:738–746.
23.
Waeber B, Erne P, Saxenhofer H, Heynen G: Use of drugs with more than a twenty-four-hour duration of action. J Hypertens 1994;12(suppl 8):S67–S71.
24.
Detry J-MR, Block P, Backer GD, Degaute JP, Six R: Patient compliance and therapeutic coverage: Amlodipine versus nifedipine (slow-release) in the treatment of angina pectoris. J Int Med Res 1994;22:278–286.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.