Abstract
Two preparations of diltiazem, controlled release (CR) given twice a day (b.i.d.) and plain given 4 times a day (q.i.d.), were compared in a multicentre, double-blind, crossover study in 41 patients with stable angina pectoris. Therapeutic efficacy was assessed with maximal exercise tests, patient recordings on nitroglycerine consumption and angina attacks. No significant differences between the CR and plain tablets were seen in any of the efficacy variables. Maximal workload significantly increased from 127 W on placebo to 146 W on CR tablets and to 147 W on plain tablets. Anginal attacks/week significantly decreased from 11.7 on placebo to 4.9 on CR tablets and to 5.0 on plain tablets. Consumption of nitroglycerine tablets/week significantly decreased from 6.3 on placebo to 2.6 and to 3.4 on CR and plain-tablets, respectively. The number or the seriousness of the adverse events did not differ between the groups. The results imply that diltiazem CR b.i.d. is equally potent and safe as conventional diltiazem q.i.d. in the control of stable angina pectoris.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chaffman M, Brogden RN (1985) Diltiazem: a review of its pharmacological properties and therapeutic efficacy. Drugs 29:387–454
Buckley MM-T, Grant SM, Goa KL, McTavish D, Sorkin EM (1990) Diltiazem: a reappraisal of its pharmacological properties and therapeutic use. Drugs 39:757–806
Gatley MS (1968) To be taken as directed. J R Coll Gen Prac 16:39–44
Källstrand P, Ekman B (1983) Membrane-coated tablets: a system for the controlled release of drugs. J Pharm Sci 72:772–775
Brorson L, Arvill A, Jörgensen E, Franzén T, Larsson H, Olsson A-M, Olsson S-O R (1994) Conventional and controlled release diltiazem. Bioavailability in healthy volunteers and antianginal effects in combination with metoprolol in stable angina pectoris. Eur J Clin Pharmacol 46:75–79
Borg GV (1982) Ratings of perceived exertions and heart rates during short term cycle exercise and their use in new cycling strength test. Int J Sports Med 3:153–158
Höglund P, Nilsson L-G (1987) Liquid chromatographic determination of diltiazem and its metabolites using transisomers as internal standards, with dynamic modification of the solid phase by addition of an amine to the mobile phase. J Chromatogr 414:109–120
Rhodda BE, Davies RL (1980) Determining the probability of an important difference in bioavailability. Clin Pharmacol Ther 28:247–252
Vliegen HW, van der Wall EE, Kragten JA, Holwerda NJ, Schenkel WM, Muijs de Moer WM, ten Kate JBL, Mulder PGH, Bruschke AVG (1993) Comparison of diltiazem standard formulation and diltiazem controlled release in patients with stable angina pectoris: a randomized, double-blind, cross-blind, cross-over, multicenter study. J Cardiovasc Pharmacol 21:552–559
Vliegen HW, van der Wall EE, Niemeyer MG, Holwerda NJ, Bernink PJLM, de Weerd P, Bosma AH, van der Wieken LR, Timmermans AJM, Molhoek GP, Mulder PGH (1991) Longterm efficacy of diltiazem controlled release versus metoprolol in patients with stable angina pectoris. J Cardiovasc Pharmacol 18 [Suppl 9]:S55-S60
Rasmanis G, Vallin H, Boukter S, Rosenqvist M, Edhag O (1989) Combination of diltiazem and metoprolol in patients with severe angina pectoris — clinical efficacy and electrophysiology. Abstract No 201, Scandinavian Congress of Cardiology, June 7–9, Reykjavik
Rasmanis G, Vallin H, Boukter S, Rosenqvist M, Edhag O (1989) Combined treatment with diltiazem-metoprolol in severe angina pectoris — preferred by the patients in comparison to each single treatment. Eur Heart J 10:P 330
Emanuelsson H, Hjalmarsson Å, Meier K, Richter A (1989) Effects of diltiazem and isosorbide-5-mononitrate, alone and in combination, on patients with stable angina pectoris. Eur J Clin Pharmacol 36:561–566
Posma JL, van Dijk RB, Lie KI (1989) Sustained-release diltiazem versus metoprolol in stable angina pectoris. Eur Heart J 10:923–927
Steffensen R, Grande P, Pedersen F, Haunsø S (1993) Effects of altenolol and diltiazem on exercise tolerance and ambulatory ischaemia. Int J Cardiol 40:143–153
Nikkilä MT, Inkovaara JA, Heikkinen JT, Olsson S-O R (1989) Antihypertensive effect of diltiazem in a slow release formulation for mild to moderate essential hypertension. Am J Cardiol 63:1227–1230
Andrén L, Höglund P, Dotevall A, Eggertsen R, Svensson A, Olsson S-O, Wadenvik H (1988) Diltiazem in hypertensive patients with type II diabetes mellitus. Am J Cardiol 62:114G–120G
Hedner T, Thulin T, Gustafsson S, Olsson S-O (1990) A comparison of diltiazem and metoprolol in hypertension. Eur J Clin Pharmacol 39:427–433
Thulin T, Hedner T, Gustafsson S, Olsson S-O (1991) Diltiazem compared to metoprolol as add-on therapies to diuretics in hypertension. J Hum Hyperten 5:107–114
Pollare T, Lithell H, Ljunghall S, Mörlin C, Präntare H, Hvarfner A (1989) Metabolic effects of diltiazem and altenolol: results from a randomized, double-blind study with parallel groups. J Hypertens 7:551–559
Platou E, Osmundsen K, Gundersen R, Lundbo C, Platou D, Rivelsrud O, Skinnermoen OE, Vig C, Øien PA (1989) A randomized double-blind multicenter long term comparison of diltiazem and nifedipine in patients with essential hypertension. Eur Heart J 10:P1538
Sarachek NS, London RL, Matolewics TJ (1985) Diltiazem and granulomatous hepatitis. Gastroenterology 88:1260–1262
Toft E, Vyberg M, Therelsen K (1991) Diltiazem-induced granulomatous hepatitis. Histopathology 18:474–475
Shallcross H, Padley SPG, Glynn MJ, Gibbs DD (1987) Fatal renal and hepatic toxicity after treatment with diltiazem. BMJ 295:1236–1237
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Boman, K., Karlsson, L.G., Saetre, H. et al. Antianginal effect of conventional and controlled release diltiazem in stable angina pectoris. Eur J Clin Pharmacol 49, 27–30 (1995). https://doi.org/10.1007/BF00192354
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00192354