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Peripheral vasodilator

Inositol nicotinate

Brand names: Hexopal

Inositol nicotinate is a peripheral vasodilator that has been used in the management of peripheral vascular disease such as intermittent claudication and Raynaud's phenomenon.

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 metabolised to release nicotinic acid (niacin), producing peripheral vasodilatation.

Prescribing in practice

  • Vasodilators are not a substitute for risk-factor modification and structured exercise in peripheral arterial disease, and clinical benefit is limited.
  • Avoid in patients with recent myocardial infarction or where vasodilatation could be harmful.
  • Use with caution in patients prone to hypotension or flushing.

Monitoring

Monitor for symptomatic benefit and vasodilatory adverse effects, reviewing the need to continue treatment.

Counselling the patient

  • Flushing and a feeling of warmth may occur.
  • Continue to exercise regularly and address smoking and other vascular risk factors.
  • Report if symptoms do not improve so treatment can be reviewed.

Evidence & guidelines

Evidence for peripheral vasodilators in claudication is weak, and NICE emphasises exercise and risk-factor management as the mainstay of treatment.

Reference: 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).

Related

Curated clinical cross-links plus same-class fallbacks.

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