Products
Molsidomine is commercially available in the form of tablets and sustained-release tablets (Corvaton). The drug has been approved in many countries since 1980.
Structure and properties
Molsidomine (C9H14N4O4, Mr = 242.2 g/mol) is a prodrug that is biotransformed in the liver to the active metabolite linsidomine (SIN-1). It exists as a white crystalline powder and is sparingly soluble in water.
Effects
Molsidomine (ATC C01DX12) has vasodilatory properties, lowers blood pressure, and relieves cardiac stress. The effects are due to the formation of nitric oxide (NO), which activates guanylyl cyclase, eventually leading to relaxation of vascular smooth muscle.
Indications
For prevention and long-term treatment of angina pectoris.
Dosage
According to the SmPC. Tablets are taken independently of meals.
Contraindications
- Hypersensitivity
- Angina pectoris, acute attack
- Acute circulatory failure
- Severe hypotension
- Lactation
- Molsidomine should not be combined with phosphodiesterase-5 inhibitors, such as sildenafil (Viagra, generics), because it can cause a dangerous drop in blood pressure.
Full precautions can be found in the drug label.
Interactions
Drug interactions are possible with phosphodiesterase-5 inhibitors, antihypertensives, and alcohol.
Adverse effects
The most common possible adverse effects include headache and lowering of blood pressure.