Comparison of once daily and twice daily nisoldipine as monotherapy in essential hypertension

Twenty-four patients completed a dose ranging study of the effect of nisoldipine as monotherapy in the treatment of hypertension. This randomized double-blind study consisted of two crossover phases in each of which once and twice daily treatment were compared. In the first treatment phase the total daily dose of nisoldipine was 10 mg, which increased to 20 mg during the second phase. Trough blood pressure measurements were made 12/24 h postdose. During the first phase the blood pressure values following treatment with nisoldipine 5 mg twice daily were significantly lower than with 10 mg once daily. However, when the daily dose was increased to 20 mg there was no significant difference between the two treatment regimens. There was also no significant difference between nisoldipine 5 mg twice daily and 10 mg twice daily but the results for 20 mg once daily were significantly lower than for 10 mg once daily. Four patients withdrew from the study because of adverse events, one while on placebo and three while on nisoldipine therapy. Between 33% and 47% of patients reported adverse events during nisoldipine treatment but the majority of adverse events reported were mild and did not require treatment withdrawal. Nisoldipine twice daily appeared to be more effective and better tolerated than once daily treatment for 24-h blood pressure control.