Abstract
The hemodynamic and antianginal efficacy of transdermal nitroglycerin (TGTN) patches were assessed in patients with chronic, stable angina pectoris. In 11 patients, acute dosing with 10,20 and 30 cm 2 of TGTN (designed to deliver 5,10 and 15 mg GTN over 24 hours) improved treadmill walking time 2 and 4 hours after application, but no clinical effects were seen at 24 hours. In a second study in 6 patients with doses of 30, 60 and 90 cm 2 of TGTN treadmill walking time was improved at 2 and 4 hours, but no changes were seen at 24 hours except with the 90-cm 2 preparation. After daily therapy with 30-cm 2 patches of TGTN for 1 to 2 weeks, exercise tolerance was similar to that seen during daily placebo therapy. These results suggest that TGTN patches are of inadequate size to produce 24-hour antianginal protection. During sustained therapy, tolerance develops to the antianginal efficacy of this form of GTN administration.
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