Indication

Angina pectoris

Administration

May be taken with or without food.

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. Contraindication Cardiogenic shock; hypotension; left ventricular failure with low filling pressure; lactation. Mode 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. Precaution Hypovolaemia, low systolic BP, acute pulmonary oedema, pregnancy. May impair ability to drive or operate machinery. Side Effect Headache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses. Interaction Hypotensive interaction may occur with alcohol, TCAs, antihypertensives and other vasodilators. Potentially Fatal: Enhanced hypotensive effect with sildenafil and other phosphodiesterase type-5 inhibitors.

Contraindication

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

Mode 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.

Precaution

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

Side effect

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

Interaction

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