Description
Nicorandil works through two key actions: vasodilation and protection against myocardial ischemia. It opens ATP-sensitive potassium channels in vascular smooth muscle cells, causing relaxation and widening of blood vessels. This improves blood flow to the heart muscle and lowers the heart’s workload. Nicorandil also has a nitrate-like effect, releasing nitric oxide which further relaxes blood vessels. These combined effects make it useful in treating angina by reducing oxygen demand and improving oxygen supply to the heart.
Uses
Doctors prescribe Nicorandil tablets for:
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Relief from angina (chest pain)
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Management of chronic stable angina and variant angina
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Improving blood flow to the heart
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Reducing frequency of angina attacks
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Enhancing exercise tolerance in angina patients
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Relaxing and widening blood vessels to lower workload on the heart
Dosage
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Usual dose: 10–20 mg twice daily (morning and evening).
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Starting dose: 10 mg twice daily, as directed by your doctor.
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Swallow whole with water.
In Case of Overdose
Overdose may cause:
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Severe low blood pressure
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Dizziness or fainting
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Persistent lightheadedness
Action: Seek emergency medical help or contact a poison control center immediately.
Missed Dose
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Take the missed dose as soon as possible.
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Skip if it is almost time for the next dose.
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Do not double the dose.
How To Use
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Swallow whole with a glass of water.
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Take consistently at the same times daily.
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Do not chew or crush the tablet.
When Not to Use
Avoid Nicorandil if you have:
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Allergy to Nicorandil or its excipients
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Recent heart attack or unstable angina
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Very low blood pressure or shock
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Aortic stenosis (narrowed heart valve)
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Severe kidney or liver disease
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Active peptic ulcer disease or GI bleeding
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Pregnancy or breastfeeding
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History of retinal hemorrhage or arterial occlusion
Side Effects
Possible side effects include:
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Headache
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Dizziness
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Nausea, vomiting, diarrhea
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Flushing and skin rashes
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Low blood pressure
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Allergic reactions (swelling of face, lips, throat)
Precautions & Warnings
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May cause dizziness when standing — rise slowly.
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Use with caution in patients with heart problems, liver/kidney disease.
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May trigger flushing and sweating.
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Not recommended in pregnancy or breastfeeding.
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Seek urgent help if chest pain worsens.
Drug Interactions
Nicorandil may interact with:
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Nitrates (risk of excessive low BP)
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Rifampicin (reduces Nicorandil effect)
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Beta-blockers / ACE inhibitors (additive low BP)
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Diuretics (risk of dehydration/electrolyte imbalance)
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Warfarin / anticoagulants (bleeding risk)
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Insulin or oral hypoglycemics (blood sugar fluctuations)
Food Interactions
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Avoid alcohol (increases risk of dizziness/low BP).
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Limit grapefruit juice (may increase drug levels).
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Avoid excess salty foods (can reduce effectiveness).
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Avoid spicy foods if they worsen flushing or stomach upset.
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High-fat meals may delay absorption.
Storage & Disposal
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Store at room temperature in a dry place, away from light.
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Keep in original packaging.
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Do not use expired tablets.
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Dispose safely via pharmacist guidance.
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Keep out of children’s reach.
Control Drug
No
Quick Tips
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Always take at the same times daily.
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Take with or without food, but be consistent.
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Do not chew or crush.
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Monitor blood pressure regularly.
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Report sudden dizziness, chest pain, or allergic reactions immediately.
Doctor’s Overview — Dr. Imran Siddiqui, MBBS, FCPS (Cardiology)
Nicorandil is a medicine used for people with long-term chest pain (angina). It helps reduce how often the pain comes and makes it easier to stay active. Headaches and dizziness are common when starting it, so drinking enough water and standing up slowly can help. People with serious heart, kidney, or liver problems should only use it with close doctor supervision.
Disclaimer
This overview is for educational purposes only. Nicorandil is a prescription medicine and should be used only under the guidance of a qualified healthcare professional.
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