Isosorbide Dinitrate and Nitroglycerin Oral Spray in Heart Failure

Nitrates are widely used for the treatment and prevention of heart failure and angina pectoris. Even the traditionally most rapid method of administration, the sublingual tablet, takes at least 2 min until the onset of effect. Usually this takes longer because 2 min is the time required from the moment of dissolution by nitrates, administered in the form of sublingual tablets, to reach peak plasma levels [1]. An additional period is, however, required for dissolution of the tablet, which must take place at least partially before absorption begins. This period shows interpatient variability, which may involve further delay of the onset of action.