PMID: 29751471Jan 1, 1991Paper

Effect of isosorbide dinitrate on non-cirrhotic portal hypertension

The National Medical Journal of India
D Ghosh RoyJ B Dilawari

Abstract

Among the many drugs including propranolol that have been evaluated for the pharmacological control of portal hypertension, isosorbide dinitrate (ISDN) fulfils the criteria of patient acceptability, ease of administration and production of the desired effect. Forty-three consecutive patients with uncomplicated noncirrhotic portal hypertension (NCPH) caused by extrahepatic portal venous obstruction (EHO=32) and non-cirrhotic portal fibrosis (NCPF=l1) were given 20 mg of ISDN sublingually and in the supine position the intrasplenic pulp pressure (ISPP) was monitored for 10 minutes. The fall in mean ISPP became significant at 4 minutes in patients with EHO (p<O.Ol) and at 6 minutes in patients with NCPF (p<0.05) and continued for the rest of the study. There was no change in the ISPP of 6 control patients with EHO who were given a placebo. The fall in ISPP did not correlate with the basal ISPP, nor with other parameters such as age, number of gastrointestinal bleeds, haemoglobin level, spleen size, premedication, presenceof large natural portosystemic shunts or obliteration of varices by sclerotherapy. Isosorbide dinitrate may be useful in treating patients with NCPH.

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