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Step2 Preparation of L-3- cyano -2-hydrooxypropyl trimethylammonium L-3-chloro-2-hydroxypropyl trimethyl ammonium (50g) was added in 250ml three-necked flask, dissolved in H2O (40ml), heated at 30C-70C, sodium cyanide (48g) was dripped, kept at 70C for 4 hours, evaporated under a reduced pressure, freezed below 0C, and dried to giveL-3-cyano -2 - hydroxypropyl trimethyl ammonium (43.8g), yield 92.1 %, m.p

Administered as sublingual drops

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These are often prescribed after a heart attack or the placement of a stent

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