Hepatic dysfunction, assessing severity

Isosorbide-5-mononitrate has been tested with and without propranolol in a placebo-controlled study in 30 patients with liver cirrhosis and esophageal varices (22). The aim of the study was to assess the severity of previously reported adverse effects (that is renal dysfunction and hepatic encephalopathy) when vasoactive drugs are used to prevent variceal bleeding. Neither isosorbide-5-mononitrate nor propranolol alone or together had any adverse effect on subclinical hepatic encephalopathy or renal function in patients with well-compensated cirrhosis. Severe headache in those taking isosorbide caused three patients to withdraw. 

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