Nicoget

Nicorandil tablets exert dual pharmacological actions: potassium channel activation and nitrate-like vasodilation. As an ATP-sensitive potassium channel opener, it hyperpolarizes vascular smooth muscle cells, promoting relaxation and dilation of epicardial coronary arteries and peripheral vessels. This reduces myocardial workload and enhances coronary blood flow. Concurrently, nitric oxide release activates guanylate cyclase, elevating cyclic GMP for additional smooth muscle relaxation. These mechanisms address myocardial ischemia by balancing oxygen supply-demand in angina conditions.

Key Benefits:

• Improves coronary perfusion and reduces cardiac oxygen consumption
• Manages chronic stable and variant angina
• Enhances exercise tolerance and decreases attack frequency
• Prevents angina symptoms through long-term vascular modulation
• Addresses coronary vasospasm
• Supports myocardial protection during ischemic episodes

How to Use

• Administration: Swallow tablet whole with a full glass of water.
• Timing: Typically twice daily; maintain consistent intervals as prescribed.
• With/Without Food: Can be taken either way; consistency preferred.
• Dosage: Follow healthcare provider’s instructions; do not alter.
• Monitoring: Regular blood pressure and heart rate assessment recommended.

Expert Tips from CureCart Direct:

• Rise slowly to minimize orthostatic hypotension risk.
• Avoid sudden position changes if dizziness occurs.
• Monitor for gastrointestinal symptoms; report persistent issues.
• Do not crush, chew, or break tablets.
• Stay hydrated; limit alcohol and caffeine intake.

Missed Dose: Take as soon as remembered unless near next dose—skip and resume schedule. Do not double dose. Contact provider for multiple misses.

Overdose: Symptoms include severe hypotension, dizziness—seek immediate medical attention for supportive care and monitoring.

Primary Uses

• Relief from angina pectoris and improved myocardial blood flow.
• Reduction of cardiac workload via vasodilation.
• Management of chronic stable angina and variant angina.
• Prevention of angina attacks and enhanced exercise capacity.
• Long-term prevention of symptoms.
• Treatment of coronary vasospasm.
• Augmentation of oxygen delivery to heart muscle.

Indications

Indicated for angina management where potassium channel activation and nitrate effects improve coronary circulation and reduce ischemic burden.

Side Effects

Common:

• Headache, dizziness, flushing
• Nausea, vomiting, diarrhea
• Skin rash or itching

Less Common:

• Hypotension
• Gastrointestinal discomfort

Serious/Rare:

• Allergic reactions (facial/lip/throat swelling)
• Severe hypotension leading to fainting
• Potential for chest pain exacerbation

Monitor for tolerance or worsening symptoms.

Warnings and Precautions

• Pregnancy/Lactation: Contraindicated; avoid unless critical need established.
• Driving: May cause dizziness—avoid until effects assessed.
• Hypotension: Risk of sudden drops; caution with position changes.
• Cardiovascular: Monitor in unstable angina history.
• Liver/Kidney Impairment: Use cautiously; dose adjustments may be required.
• Gastrointestinal: Watch for ulcers or bleeding risks.
• Other: Report severe flushing, sweating, or persistent chest pain immediately.

Contraindications

Do not use in:

• Hypersensitivity to Nicorandil or excipients.
• Unstable angina or recent myocardial infarction.
• Severe hypotension or shock.
• Aortic stenosis.
• Active peptic ulcer disease or GI bleeding history.
• Severe renal or hepatic impairment.
• Neutropenia or low white cell conditions.
• Retinal hemorrhage or artery occlusion history.
• Pregnancy or breastfeeding.

Drug Interactions

• Nitrates: Excessive hypotension risk.
• Rifampicin: May reduce Nicorandil efficacy via enzyme induction.
• Antihypertensives (beta-blockers, ACE inhibitors): Additive blood pressure effects.
• Diuretics: Increased dehydration/electrolyte imbalance potential.
• Antidiabetics (insulin, oral agents): Monitor blood glucose.
• Vasodilators: Enhanced hypotensive effects.
• Anticoagulants (e.g., warfarin): Potential clotting interference.

Inform doctor of all concurrent therapies.

Food Interactions

• Limit alcohol: Heightens flushing, dizziness, hypotension.
• Caution with grapefruit: May elevate drug levels via metabolism interference.
• Reduce caffeine: Possible heart rate/blood pressure variability.
• Avoid high-fat meals: May delay absorption.
• Limit salt: Counteracts vasodilatory effects.
• Dairy caution: Potential absorption reduction; prefer water.
• Avoid spicy foods: May worsen GI effects or flushing.

Storage/Disposal

Store at room temperature in a dry, secure place protected from light and moisture. Keep in original tightly sealed container. Avoid bathrooms, kitchens, or heat sources. Check expiry dates. Do not flush or drain dispose; consult pharmacist for safe methods. Keep inaccessible to children.

Doctor Review

Dr. Ahmed Khan, MBBS, FCPS – Consultant Cardiologist “Nicorandil’s dual mechanism—ATP-sensitive potassium channel activation coupled with nitrate-mediated nitric oxide release—provides balanced vasodilation of coronary and peripheral vessels, effectively modulating myocardial oxygen supply-demand mismatch in angina. The hyperpolarization-induced smooth muscle relaxation reduces preload and afterload, while guanylate cyclase activation via cyclic GMP further enhances coronary perfusion. Clinical profiles highlight hypotension as a primary pharmacodynamic concern, particularly with concurrent vasodilators, alongside gastrointestinal ulceration risks from nitrate moiety. Patient selection excludes those with outflow tract obstruction or acute coronary events, emphasizing hemodynamic monitoring in hepatic/renal compromise.”

FAQs

How does Nicorandil work? Opens potassium channels for hyperpolarization and releases NO for cyclic GMP-mediated relaxation, dilating vessels.

Why dizziness? From vasodilation-induced hypotension; rise slowly.

Safe with blood pressure meds? Additive effects; close monitoring required.

GI risks? Possible ulcers; report bleeding or persistent pain.

Overdose handling? Emergency care for severe hypotension symptoms.

Related Tests: Blood pressure, ECG, renal/liver function, electrolytes.

Quick Tips:

• Consistent twice-daily timing.
• Whole tablet with water.
• BP/heart rate monitoring.
• Cool, dry storage away from light.

Disclaimer: This information is for educational purposes only and not a substitute for professional medical advice. Always consult a qualified physician before use. CureCart Direct ensures accurate details but cannot cover all interactions or precautions. Prices and availability subject to change.