Nicorandil is an antianginal medication that works by dilating diseased coronary arteries vessels to promote blood flow to the heart muscle.

Mode of action

Nicorandil has a dual mode of action: as a potassium channel activator and also as a vasodilatory drug with properties similar to those of nitrates. In the UK nicorandil is marketed under the brand name Ikorel.

Nicorandil is a twice daily table used normally as a second line antianginal in combination with beta-blocker or calcium channel blocker. Your GP may start you on low dose and then may increase the dose according to the condition.

Adverse effects

Nicorandil is normally considered safe but the vasodilatory mode of action can lead to low blood pressure (hypotension), particularly in the elderly, in dehydration, in combination with antihypertensives and other blood pressure lowering drugs (including erectile dysfunction drugs). Alcohol increases the effects of nicorandil. Common side effects include nausea, flushing, palpitations, dizziness and ulcerations in the mouth and elsewhere in the digestive system.