Nicorandil

Indications

Nicorandil is used for: Angina pectoris

Adult Dose

Oral Angina pectoris Adult: 10 mg bid, increase if necessary. Usual dose: 10-20 mg bid. May use 5 mg bid for patients prone to headache. Max dose: 30 mg bid. Hepatic impairment: Dose reduction may be necessary.

Child Dose

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Cardiogenic shock; hypotension; left ventricular failure with low filling pressure; lactation.

Precautions

Hypovolaemia, low systolic BP, acute pulmonary oedema, pregnancy. May impair ability to drive or operate machinery.

Pregnancy-Lactation

Interactions

Hypotensive interaction may occur with alcohol, TCAs, antihypertensives and other vasodilators. Potentially Fatal: Enhanced hypotensive effect with sildenafil and other phosphodiesterase type-5 inhibitors.

Adverse Effects

Side effects of Nicorandil : Headache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses.

Mechanism of Action

Nicorandil dilates arterioles and large coronary arteries by opening the potassium channels, and stimulates guanylate cyclase causing venous vasodilatation. It therefore reduces preload and afterload, and improves coronary blood flow.