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Molsidomine is an orally active, long-acting vasodilator of the syndnone class used primarily for the prevention and long-term treatment of stable and unstable angina pectoris, including in patients with left heart failure or following acute myocardial infarction. It acts as a prodrug that is metabolized in the liver to linsidomine (SIN-1), which then releases nitric oxide (NO). The NO stimulates soluble guanylate cyclase, increasing cyclic GMP levels and leading to relaxation of vascular smooth muscle, resulting in vasodilation and reduced myocardial oxygen demand. Unlike organic nitrates, molsidomine does not induce tolerance with prolonged use. It also has antiplatelet effects due to its mechanism of action[1][2][6][8].
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