Nicorandil (Ikorel): now second-line treatment for angina – risk of ulcer complications
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Updated advice on use of nicorandil as second-line treatment for stable angina – some ulcers may progress to complications unless treatment is stopped.
Advice for healthcare professionals:
Use nicorandil for treatment of stable angina only in patients whose angina is inadequately controlled by first line anti-anginal therapies, or who have a contraindication or intolerance to first line anti-anginal therapies such as beta-blockers or calcium antagonists
Nicorandil can cause serious skin, mucosal, and eye ulceration, including gastrointestinal ulcers which may progress to perforation, haemorrhage, fistula, or abscess
Stop nicorandil treatment if ulceration occurs—consider the need for alternative treatment or specialist advice if angina symptoms worsen
Please continue to report suspected adverse drug reactions to nicorandil or any other medicines on a Yellow Card
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