{blacktriangledown}Nicorandil for angina

doi:10.1136/dtb.1995.331289

Drug and Therapeutics Bulletin 1995;33:89-91; doi:10.1136/dtb.1995.331289

${blacktriangledown}$ Nicorandil for angina

Relevant BNF section: 2.6.3

Nicorandil (Ikorel - Rhône-Poulenc Rorer; Merck &Lipha) is marketed for the prevention and long-term treatmentof angina pectoris. The drug, which has been used in Japan forabout ten years, was introduced in the UK last year as the firstof a new class of anti-anginal drug. Nicorandil combines theproperties of an organic nitrate with those of a potassium-channelactivator, causing dilatation of coronary arteries and arterioles,systemic resistance vessels and veins. The manufacturer claimsthat nicorandil is 'effective monotherapy for up to 80% of patients',that 'efficacy is sustained because haemodynamic tolerance doesnot occur' and that the drug 'frees patients from many of thelimitations of earlier therapies'. We examine these claims.