A fixed-dose combination of furosemide and spironolactone in digitalized congestive heart failure patients.

Twenty-three optimally digitalized patients with congestive heart failure completed a 4-week treatment period with a fixed-drug association of 20 mg furosemide plus 50 mg spironolactone. Eleven patients responded with a 75% decrease in cardiac failure score on a daily dose of 1 capsule of the combination. The remaining 12 patients were initiated on the same dose, but needed, at the end of the first 14 days, an additional capsule (making a daily total of 40 mg furosemide and 100 mg spironolactone) over the next 2 weeks. On this dose, the patients achieved an average reduction of 52% in their cardiac failure score. There were no treatment failures. Electrolyte abnormalities and side-effects were not observed. The combination product, in a daily dose of 1 or 2 capsules, was found useful and well tolerated in the management of congestive heart failure.

The treatment of non-digitalized congestive heart failure patients with a fixed-dose combination of furosemide and spironolactone.

Seventeen non-digitalized congestive heart failure patients were treated with only the fixed-dose combinations of 20 mg furosemide and 50 mg spironolactone or 20 mg furosemide and 100 mg spironolactone, in a daily dose of 1 or 2 capsules, over a 4-week period. The selected patients had a severity rating ranging between Grades III and IV. Ten of these patients had a severe grade of dyspnoea. Assessments were made on the basis of the reduction in cardiac failure score, extent of reduction in oedema, and relief of dyspnoea. Safety variables measured included laboratory, echocardiographic and side-effect monitoring. By the end of the 4-week study period, significant reduction (46% to 51%) in cardiac score and complete relief of dyspnoea with no adverse effects on safety variables were recorded. These results indicate that it is possible to treat patients with congestive heart failure safely with the fixed-dose combination product without the concurrent use of digitalis.

Hemodynamic effects of molsidomine vasodilatory therapy in acute myocardial infarction.

The hemodynamic effects and duration of action of 4 mg of intravenous molsidomine (M), a new peripheral vasodilator antianginal agent, were evaluated and compared to those of 10 mg sublingual isosorbide dinitrate (ISDN) in 12 patients with uncomplicated acute myocardial infarction (AMI). Both M and ISDN produced marked decreases in mean right atrial pressure (RAP), mean pulmonary capillary wedge pressure (WP), and mean pulmonary arterial pressure. The maximal decreases in RAP (-56%) and WP (-35%) with intravenous M intended to be more pronounced than with sublingual ISDN (RAP-35% and WP-29%). Physiologic modest declines in systemic vascular resistance, cardiac output, and arterial pressure were similar with the both drugs. The duration of action of M was longer (average 5 hours) than that of ISDN (2 hours). No patient experienced hypotension, tachycardia, or other adverse responses following M, suggesting that M is well isolated by patients with normotensive AMI.