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Nicorandil – Drug review

Angina pain is becoming a more common desease in heart patients. Nicorandil is one of the common drugs used in the treatment of Angina. The drug can be categorised as a vasodilatory drug.

Nicorandil has different brand names in diferent countries. In UK, Australlia and Europe under the trade name of Ikorel. The drug is called Dancor in Switzerland, Aprior in Philippines, Nitorubin in Japan. The United States of America has not approved Nicorandil and is therefore not available in the United States.

How does Nicoradil Act

The action of Nicorandil is understood to be by the process of smoothing the smooth muscle of the blood vessels. The action is especially especially marked in case of the venous system.

Nicoradil acts by activating potassium channels, and by donating nitric oxide to activate the enzyme guanylate cyclase. The enzyme Guanylate cyclase causes activation of cGMP which in turn leads to arterial and venous vasodilatation by de-phosphorylation of the myosin light chain. Being selective for vascular potassium channels, Nicorandil has no significant action on cardiac contractility and conduction.

Nicorandil can dilate the coronary vessels of a healthy individual, however, its effects on the coronary vessels of someone with ischaemic heart disease will be small as they will already be completely dilated. Instead, it dilates the venous system, reducing preload and the work of the heart.

Side effects of Nicorandil

The most prominent side effect of Nicorandil include the mouthulcers. Other side effects include palpitation, weakness, headache, nausea and vomiting. Other reported side effects include peri-anal, ileal and peri-stomal ulceration. The British National Formulary includes Anal ulceration as a reported side effect.

Nicordil has also been reported to give severe toothache, and nasal congestion.

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