Nicorandil: reminder of advice for healthcare professionals

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

From MHRA Drug Safety Update 21 January 2016