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Double-Blind Comparison of Prenylamine and Penbutolol in Patients with Angina Pectoris

This study was performed to re-evaluate the clinical position of prenylamine in the management of angina pectoris. After 1 week withdrawal of all anti-anginal agents, followed by another week of placebo administration, seventeen patients were allocated at random to 6 weeks treatment with either Penbutolol 40 mg once a day or prenylamine 60 mg t.i.d. Clinical examination, exercise test and anginal attack rate were recorded every 2 weeks. Both drugs reduced the anginal attack rate. None of the drugs caused a significant increase in maximal workload or a significant change in ST-segment depression. Beside a substantially lower rate-pressure product at maximal comparable workload in the Penbutolol group (p < 0·001), no significant differences were observed between the two drugs. No adverse reactions were reported. From these results one can conclude that prenylamine and Penbutolol do not differ in their anti-anginal effect. Therefore we are of the opinion that prenylamine has a place in the therapeutic armamentarium for the management of angina pectoris, particularly inpatients where beta-blocking agents are contraindicated or in patients who have experienced side-effects of beta-blocking or calcium-entry blocking agents.