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Erythrityl tetranitrate is a long-acting organic nitrate vasodilator used primarily for the prevention and long-term management of angina pectoris and coronary insufficiency. It acts by being converted to an active intermediate that activates guanylate cyclase, increasing cyclic guanosine monophosphate (cGMP) levels in vascular smooth muscle. This leads to protein kinase-dependent phosphorylation events, dephosphorylation of myosin light chains, reduced intracellular calcium, relaxation of smooth muscle cells, and vasodilation. Erythrityl tetranitrate is classified as an organic nitrate with pharmacological properties similar to nitroglycerin and is indicated for patients with frequent or recurrent anginal pain or during postcoronary convalescence[1][2][3][5].
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