Source: Pulmonology  |  Posted 9 years ago

While cirrhotic patients with ascites can tolerate isosorbide-mononitrate, it is ineffective. On the other hand, the beta-blocker nadolol is effective but not nearly as well tolerated.

Noting that beta-blockers effectively prevent first variceal bleeding in cirrhotic patients but that patients with ascites could not use them because of their many contra-indications and side-effects, researchers in Milan and Magenta, Italy, compared the efficacy and applicability of nadolol and isosorbide-mononitrate in preventing first variceal bleeding in 80 consecutive cirrhotic patients.

These patients had ascites and oesophageal varices with a high risk of bleeding - a 25 percent average risk at one year. Of the 80 patients, 28 were excluded because of contra-indications, leaving 52 to be randomly assigned to receive the beta-blocker (n=25) or the nitrate (n=27).

The frequency of contra-indications with nadolol was 35 percent. There were no contra-indications with isosorbide-mononitrate.

During follow-up of 21.3