Nicorandil

Oral
Angina pectoris

Dose reduction may be necessary.

May be taken with or without food.

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

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

Headache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses.

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

Description: 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.
Pharmacokinetics:
Absorption: Absorbed well from the GI tract (oral); peak plasma concentrations after 30-60 min.
Distribution: Protein-binding: Slightly bound.
Metabolism: Denitration.
Excretion: Via urine (as metabolites); 1 hr (elimination half-life).

Anti-Anginal Drugs