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Angina - stable - Management
What dose and formulation of nitrate should I prescribe?
- Standard-release nitrate preparations: use an asymmetric dosing interval to minimize nitrate tolerance.
- For mononitrate preparations, this can be achieved with twice-daily dosing, for example at 8 a.m. and 3 p.m., or 2 p.m. and 10 p.m.
- For dinitrate preparations, dosing may be more complicated because dinitrate requires more frequent administration than mononitrate.
- Modified-release nitrate preparations: use a once-daily dose to maintain a nitrate-low period and thus minimize tolerance.
- Modified-release preparations are significantly more expensive than standard-release preparations, but they may be useful for people who find it difficult to comply with an asymmetric dosing regimen.
In depth
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