BMA Concise Guide to Medicine & Drugs

Nicorandil

Brand name Ikorel

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anti-angina drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Nicorandil is the only generally available member of a group of drugs known as potassium channel openers. It is used to treat angina pectoris.

The symptoms of angina result from the failure of narrowed coronary blood vessels to deliver sufficient oxygen to the heart. Nicorandil acts by widening blood vessels by a different mechanism to other anti-angina drugs, and is notable because it widens both veins and arteries. As a result of this, more oxygen-carrying blood reaches the heart muscle and the heart’s work load is reduced since the resistance against which it has to pump is decreased.

Nicorandil is as effective as other drugs used to treat angina, and when used in combination with others may add to their effects.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets.

Frequency and timing of doses 2 x daily.

Adult dosage range 10–60mg daily.

Onset of effect Within 1 hour.

Duration of action Approximately 12 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 4 hours, take a single dose now and skip the next.

Stopping the drug Do not stop taking the drug without consulting your doctor; stopping the drug may lead to worsening of the underlying condition.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause unusual dizziness and dangerously low blood pressure. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Adverse effects are generally minor and usually wear off with continued treatment, although a dose reduction may be necessary in some cases. Headache, flushing, nausea, and vomiting are common; discuss with your doctor if these are severe or if you develop mouth ulcers. If dizziness, weakness, jaundice, facial swelling, or rash occur, contact your doctor; in the case of a rash, your should also stop taking the drug. If you experience palpitations, stop taking the drug and contact your doctor immediately.

INTERACTIONS

Antihypertensive drugs Nicorandil may increase the effects of these drugs.

Sildenafil, tadalafil, and vardenafil increase the effects of nicorandil on blood pressure and should not be used with nicorandil.

MAOI and tricyclic antidepressant drugs may increase the effects of nicorandil on blood pressure, resulting in dizziness.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have low blood pressure.

· You have other heart problems.

· You have a history of angioedema.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Reduced dose may be necessary.

Driving and hazardous work Avoid such activities until you have learned how nicorandil affects you because the drug can cause dizziness as a result of lowered blood pressure.

Alcohol Avoid until you are accustomed to the effect of nicorandil. Alcohol may further reduce blood pressure, causing dizziness or other symptoms.

PROLONGED USE

No problems expected.