Nicorandil is a drug for treatment of angina which works smillarly to nitrates by relaxing the walls of the coronary arteries to improve blood flow to the heart muscle. Nicorandil is a potassium channel activator and its UK brand name is Ikorel. Nicorandil is a twice daily tablet used normally as a third- or fourth line antianginal in combination with a beta-blocker or a calcium channel blocker. Nicorandil is usually started on low dose and then may increased according to the response.
Nicorandil is normally considered safe but the vasodilatory mode of action can lead to low blood pressure (hypotension), particularly in the elderly, in dehydration, in combination with antihypertensives and other blood pressure lowering drugs including medication for erectile dysfunction, such as sildenafil (Viagra). Alcohol increases the effects of nicorandil. Nicorandil is normally well tolerated. Side effects include nausea, flushing, palpitations and dizziness. Relatively rare but potentially serious side effect is ulcerations in the mouth and elsewhere in the digestive system.