Angispan TR and Isosorbide Dinitrate: Understanding the Relationship
Yes, Angispan TR is a brand name for isosorbide dinitrate, making them the same medication with different names. Isosorbide dinitrate is an organic nitrate that functions as a vasodilator, affecting both arteries and veins 1.
Pharmacological Properties
- Isosorbide dinitrate is a white, crystalline compound that is stable in air and solution, with a melting point of 70°C 1
- It acts as a vasodilator with effects on both arteries and veins, primarily working through preload reduction via venodilatation 2
- The medication serves as a physiological substitute for endothelium-derived relaxing factor in patients with endothelial dysfunction 2
Clinical Applications
- Isosorbide dinitrate is primarily indicated for the prevention of angina pectoris due to coronary artery disease 1
- It is not recommended for aborting acute anginal episodes due to its insufficiently rapid onset of action 1
- In heart failure management, isosorbide dinitrate is often used in combination with hydralazine, particularly in specific patient populations 3
Formulations and Dosing
- Isosorbide dinitrate is available in various formulations, including immediate-release and sustained-release (like Angispan TR) 4
- Immediate-release formulations are typically dosed multiple times daily, while sustained-release formulations may allow for once or twice-daily dosing 4, 5
- When used for angina, isosorbide dinitrate provides protection for approximately 2.5-3 hours, compared to nitroglycerin's 1-hour protection 6
Clinical Considerations
- Tolerance is a significant concern with nitrate therapy, characterized by a loss of anti-ischemic effects with continuous use 2
- To prevent tolerance development, a daily nitrate-free interval is recommended, particularly with sustained-release formulations 2, 4
- Common side effects include headache, dizziness, and gastrointestinal complaints, which are usually mild to moderate and improve with continued therapy 3, 5
Use in Heart Failure
- In heart failure treatment, isosorbide dinitrate is primarily used in combination with hydralazine 3
- This combination has shown particular efficacy in African American patients with heart failure with reduced ejection fraction (HFrEF) 3
- For non-African American patients with HFrEF who cannot tolerate ACE inhibitors or ARBs, the hydralazine-isosorbide dinitrate combination may be considered as an alternative therapy 3
Comparison with Other Nitrates
- Isosorbide dinitrate differs from nitroglycerin in its duration of action and pharmacokinetics 3
- Isosorbide-5-mononitrate (a metabolite of isosorbide dinitrate) has been studied more recently and may offer advantages in terms of dosing frequency and tolerance development 4, 5
- In comparative studies, isosorbide mononitrate has shown similar efficacy to calcium channel blockers like diltiazem for stable angina management 7
In conclusion, Angispan TR is a brand name for isosorbide dinitrate, and they are pharmacologically identical. Understanding this equivalence is important for proper medication management and to avoid potential confusion about different formulations of the same active ingredient.