Erythrityl Tetranitrate is a vasodilator indicated for the prevention of angina. Sold under the brand name Cardilate, Erythrityl Tetranitrate is used for the prophylaxis and long-term treatment of patients with frequent or recurrent anginal pain or coronary insufficiency and during the postcoronary convalescent period to hasten recovery. Similar to other nitrites and organic nitrates, erythrityl tetranitrate is converted to an active intermediate compound which activates the enzyme guanylate cyclase. This stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) which then activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation. Erythrityl Tetranitrate is a is an atrial natriuretic peptide receptor agonist. Erythrityl tetranitrate is a physiologically effective long-acting agent in patients with coronary heart disease.