Molsidomine: Composition, Uses, Dosage, Side Effects, Contraindications, Interactions and Storage

It is an effective long-acting anti-anginal drug.

Molsidomine is a prolonged-release vasodilator, which requires liver activity, but does not cause drug tolerance.

Molsidomine is a NO-releasing medicine. Esterases in the liver produce molsidomine in the active metabolite, SIN-1 (plasma half-life is 1-2 hours), releasing NO.

Each tablet contains molsidomine 2/4 mg.

Composition and uses of molsidomine

Molsidomine – 2: Each enteric-coated tablet contains 2 mg multidomain.

Molsidomine – 4: each enteric-coated tablet contains 4 mg multidomain.

This medicine is used to:


  • The prevention and treatment of the symptoms of angina pectoris.
  • Coronary insufficiency.
  • For the improvement of stress tolerance in ischemic heart disease.


  • Oral heart failure Adult: 1-4 mg 2-4 times a day.
  • Postoral myocardial infarction Adult: 1-4 mg 2-4 times a day.
  • Intravenous angina pectoris Adult: 2-4 mg in a single dose

Side Effects of Molsidomine

The following side effects may appear such as:

  • Circulatory disorders: decrease in blood pressure, especially when standing.
  • Central nervous system disorders: headache (early treatment, gradually disappearing), dizziness.
  • Gastrointestinal disorders: nausea.
  • Skin disorders and subcutaneous tissue disorders: redness, rash.


  • Orthostatic hypotension.
  • Vertigo.
  • Itching.

Pregnancy and breastfeeding

Molsidomine in pregnant women, especially in the first trimester, is contraindicated.

In lactation, you should consult your doctor before starting treatment.

The use of molsidomine in lactating women is contraindicated.


  • Hypotension marked with shock.
  • Sildenafil association: in any patient treated with molsidomine, the sildenafil should not be prescribed while the patient is under the action of molsidomine.

In a patient without a coronary history who presents a first episode of angina after sexual activity, it is advisable to ask a question about the possible taking of sildenafil (more often, in the hour before sexual activity) and if this is the case. to refrain from anything with molsidomine.

  • Due to the presence of lactose, this drug is contraindicated in cases of congenital galactosemia, glucose-galactose malabsorption syndrome, or lactase deficiency.

Precautions for the use of molsidomine


  • The combination of molsidomine with sildenafil can cause a significant and sudden drop in blood pressure, which may cause fainting, syndrome, or acute coronary events.

Employment precautions

  • A slight decrease in blood pressure is familiar with molsidomine. Caution should be exercised in hypotensive patients, particularly in elderly and hypovolemic patients (acute or chronic depletion of saltwater) and in patients who have already been treated with a vasodilator.
  • Progressive dosing is recommended in case of hepatocellular failure.
  • Without any myocardial depressant effect, molsidomine may be associated with beta-blockers. It does not affect the conduction tissue.
  • The substitution of the delay of the nitrate derivatives is more logical than the association due to joint action in the preload.

Molsidomine interactions

  • Iloprost.
  • Sildenafil.


The following are symptoms of overdose:

  • Headache.
  • Hypotension
  • Tachycardia.

When significant hypotension is present, it can be combated by placing the patient in a supine position, with the head tilted, with the elevation of the legs, and, when necessary, an intravenous injection of standard solution.

The risk of significant hypotension (synergistic effect) can aggravate the state of myocardial ischemia and cause, in particular, an acute coronary event.

Driving and using vehicles

The drug does not affect the ability to drive and use vehicles.

Storage and other instructions for molsidomine

  • Store this product at temperatures below 25 degrees C
  • Protect from light.
  • Keep out of the reach of children.
  • Do not use molsidomine after the expiry date stated on the carton.