Stable Angina

Nicorandil

Brand names: Ikorel

Nicorandil is an antianginal used for stable angina, usually when standard treatments 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 is a potassium-channel activator with a nitrate component, dilating arteries and veins to reduce cardiac preload and afterload and improve coronary flow.

Prescribing in practice

Headache is very common, especially initially.
It can cause serious ulceration anywhere in the gastrointestinal tract (mouth, anal and gut ulcers and fistulae) — stop it and seek advice if ulcers develop, and do not mistake them for other conditions.
Like nitrates, it is contraindicated with PDE5 inhibitors (e.g. sildenafil).

Monitoring

Review angina control and ask about mouth, anal or other ulceration.

Counselling the patient

Headache is common at first and usually settles.
Report any persistent mouth, anal or gut ulcers — tell your clinician you take nicorandil.
Never use it with erectile-dysfunction tablets such as sildenafil.

Evidence & guidelines

An option for stable angina where first-line therapy is insufficient (NICE CG126), with awareness of its ulceration risk.

Reference: IONA Trial (Lancet 2002); MHRA DSU 2011 (GI Ulceration); NICE CG126 (Stable Angina); SPC Ikorel; 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