Nicorandil

Dosage Forms Available

• Nicorandil is available in oral tablet form.

Age and Dose Restrictions

• Nicorandil is not recommended for children and adolescents under 18 years.

Contraindications

• Nicorandil is contraindicated in patients with low blood pressure, severe kidney or liver disease, heart failure, or those with a history of bleeding in the digestive system (e.g., stomach ulcers or perforations). It should not be used in patients taking phosphodiesterase-5 inhibitors (such as sildenafil, tadalafil, or vardenafil), as this can cause a dangerous drop in blood pressure.

Other Medications to Avoid

• Avoid taking nitrate-based medications (like nitroglycerin or isosorbide dinitrate), antihypertensives (such as beta-blockers and calcium channel blockers), NSAIDs (such as ibuprofen and naproxen), corticosteroids, and certain antidepressants (like amitriptyline). These medications can increase the risk of severe low blood pressure, dizziness, or gastrointestinal complications.

Overdose and Missed Dose

• An overdose may cause severe low blood pressure, rapid heartbeat, fainting, or extreme dizziness. Seek immediate medical help if an overdose is suspected.
• If a dose is missed, take it as soon as you remember. However, if it is close to the next scheduled dose, skip the missed dose and continue with the regular schedule. Do not double the dose to compensate for the missed one.

Management of Side Effects

• To manage dizziness or low blood pressure, get up slowly from a sitting or lying position and avoid sudden movements. If headaches occur, they usually subside after a few days. Drinking plenty of water and taking mild pain relievers (if approved by your doctor) may help. If mouth ulcers develop, inform your doctor, as they can sometimes require discontinuation of the medication.

Use in Driving and Operating Machinery

• Nicorandil may cause dizziness or drowsiness, especially at the beginning of treatment. Avoid driving, operating heavy machinery, or performing tasks that require full alertness until you know how the medication affects you.

Use in Pregnancy and Lactation

• Nicorandil should not be used during pregnancy unless absolutely necessary. Pregnant women should consult their doctor before taking this medication. It is not recommended for breastfeeding mothers, as it is unknown whether it passes into breast milk.

Caution in Other Conditions

• Patients with kidney or liver disease, dehydration, peptic ulcers, or a history of bleeding disorders should take Nicorandil under strict medical supervision. This medication may worsen gastrointestinal ulcers and should be used cautiously in individuals prone to digestive issues.

Special Dietary and Lifestyle Recommendations

• Reduce the intake of salty and fatty foods, as they can worsen heart conditions.
• Avoid alcohol, as it can increase dizziness and worsen low blood pressure.
• Engage in regular physical activity, such as walking or light exercise, but avoid overexertion.