Potassium channel activator with nitrate component

Nicorandil

Brand names: Ikorel

Nicorandil is a potassium-channel-activator anti-anginal used when standard agents are insufficient or not tolerated.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It combines nitrate-like venodilation with arterial dilation through potassium-channel opening, reducing cardiac preload/afterload and improving coronary blood flow.

Prescribing in practice

It can cause serious ulceration of skin, mucosa and the gastrointestinal tract (mouth, anal and gastrointestinal ulcers, fistulae or perforation) — investigate any ulceration and usually stop the drug.
Headache is common early in treatment.
It is contraindicated with phosphodiesterase-5 inhibitors (e.g. sildenafil) and in significant hypotension.

Monitoring

Review for ulceration at any site and for blood pressure/headache.

Counselling the patient

Report any persistent mouth, skin, anal or gut ulcers — they can be caused by this medicine.
Do not take erectile-dysfunction drugs such as sildenafil with it.
Headaches at the start often settle.

Evidence & guidelines

An add-on anti-anginal in stable angina (NICE NG185 pathway), with an important ulceration warning.

Reference: NICE CG126; MHRA Drug Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways