Nicorandil

What nicorandil is for

Nicorandil is used to treat chest pain caused by angina.

It works by relaxing and widening your blood vessels, increasing the blood and oxygen supply to your heart.

How to take nicorandil

Nicorandil comes as tablets that you swallow. You'll usually take it twice a day.

You'll usually need to take nicorandil long term, often for the rest of your life. Do not stop taking it unless your doctor tells you to.

When taking nicorandil:

• swallow the tablets with a glass of water (do not crush or chew them)
• the tablets have a score line across the middle – you can break them in half if your doctor asks you to take a smaller dose
• you can take it with or without food

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

If you miss a dose of nicorandil

If you forget to take a dose of nicorandil, take it as soon as you remember unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much nicorandil

Taking an extra dose of nicorandil is unlikely to cause problems, but it's important to get medical advice if you take too much as it can sometimes be dangerous.

Side effects of nicorandil

Like all medicines, nicorandil can cause side effects, although not everyone gets them.

Common side effects

Common side effects of nicorandil include:

• headaches
• feeling sick (nausea) or being sick (vomiting)
• flushing – where your face, neck or chest suddenly feel hot and look red (redness may be harder to see on black or brown skin)
• dizziness and weakness

If you feel dizzy or weak while taking nicorandil, do not drive, ride a bike or use machinery until this has stopped.

Serious side effects

Nicorandil can sometimes cause serious side effects, although most of them are rare.

Possible serious side effects of nicorandil include:

• a serious allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raise, itchy rash and difficulty breathing
• corneal ulcers – causing symptoms such as eye pain and sensitivity to light
• stomach ulcers – causing symptoms such as stomach pain, feeling or being sick, loss of appetite and blood in your poo
• painful ulcers on the skin, or inside your genitals, bottom or nose

Who can and cannot take nicorandil

Most adults can take nicorandil, but it's not suitable for everyone.

For example, it may not be suitable if:

• you've had an allergic reaction or serious side effect from nicorandil or a similar medicine
• you have low blood pressure (hypotension)
• you have a problem with fluid build-up in the lungs (pulmonary oedema)
• you've recently had heart problems
• you have low blood potassium levels and are taking potassium supplements
• you have kidney problems
• you have a genetic condition called glucose-6-phosphate dehydrogenase deficiency
• you have a digestive condition called diverticular disease, which affects the large intestine

Before taking nicorandil, tell your doctor if you have any medical conditions.

Breastfeeding and nicorandil

Tell your doctor if you're breastfeeding.

Nicorandil is not usually recommended while you're breastfeeding as there is not enough information about whether it could have any effects on your baby.

But your doctor may recommend you take nicorandil if the benefits to you outweigh the risks to your baby. Or they may recommend you try a different medicine while you're breastfeeding.

If you're taking nicorandil while breastfeeding, speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Pregnancy and nicorandil

Nicorandil is not recommended for use in pregnancy as there is not enough information about whether it could have any effects on your baby.

Tell your doctor if you're pregnant or planning a pregnancy. They may suggest switching to another medicine or stopping taking nicorandil while you're pregnant.

Taking nicorandil with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with nicorandil.

This includes some types of:

• medicines for high blood pressure
• medicines for erection problems (erectile dysfunction), such as sildenafil (Viagra)
• antidepressants, such as amitriptyline
• muscle relaxants, such as baclofen
• medicines for Parkinson's disease
• non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin
• steroid tablets
• potassium supplements

This is not the full list of medicines that may not mix well with nicorandil. Before taking nicorandil, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with nicorandil

Do not use salt substitutes (such as LoSalt) if you're taking nicorandil, as they can make the level of potassium in your blood too high.

It's best not to drink alcohol while taking nicorandil as it may increase the risk of side effects like feeling dizzy or light-headed.