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Administration
May be taken with or without food.
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Contraindications
Acute pulmonary oedema, severe hypotension, cardiogenic shock, cardiac decompensation, hypovolaemia, left ventricular failure with low filling pressure. Coadministration with phosphodiesterase 5 (PDE-5) inhibitors and soluble guanylate cyclase stimulators (e.g. riociguat).
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Special Precautions
Patient with heart failure (NYHA class III and IV), hypertrophic obstructive cardiomyopathy, aortic stenosis, low systolic blood pressure, diverticular disease G6PD deficiency, glaucoma, hyperkalaemia. Renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure and heart rate.
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Adverse Reactions
Significant: Gastrointestinal ulceration which may lead to perforation, fistula, abscess formation, and haemorrhage; skin or mucosal ulceration (e.g. perianal, genital or parastomal ulceration), severe hypotension, dose-related headache (particularly during initial dosing). Rarely, severe hyperkalaemia, ocular effects (e.g. conjunctivitis, conjunctival and corneal ulcers).
Cardiac disorders: Chest pain, palpitation.
Gastrointestinal disorders: Nausea, vomiting, abdominal pain, rectal bleeding, dyspepsia.
General disorders and administration site conditions: Weakness, lethargy.
Infections and infestations: Skin abscess.
Investigations: Increased heart rate.
Musculoskeletal and connective tissue disorders: Myalgia, back pain.
Nervous system disorders: Dizziness, vertigo.
Respiratory, thoracic and mediastinal disorders: Dyspnoea, bronchitis, respiratory tract disease.
Skin and subcutaneous tissue disorders: Rash, angioedema.
Vascular disorders: Cutaneous vasodilation, flushing.
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Drug Interactions
Increased risk of gastrointestinal ulceration and haemorrhage with NSAIDs and aspirin. Increased risk of gastrointestinal perforation with corticosteroids. Hypotensive effects may be increased with antihypertensive drugs, other vasodilators, and TCAs. May increase the risk of hyperkalaemia with other agents that elevate serum K levels. Enhanced orthostatic hypotensive effect with dapoxetine.
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CIMS Class
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ATC Classification
C01DX16 - nicorandil ; Belongs to the class of other vasodilators used in cardiac diseases.
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