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Nicorandil: stop!

The angina drug nicorandil should be banned due to its negligible efficacy and potentially severe toxicity.

For treating angina, betablockers, or, secondly, amlodipine or verapamil are the drugs with the most favourable risk-benefit balance.

Nicorandil’s efficacy is minimal. It is already known to cause chronic painful ulcers in the mouth, intestine, anus, and possibly the cornea. It was also implicated in one case of severe vaginal ulceration, resulting in a hysterectomy and unsuccessful vaginal wall repair. After three years of therapeutic failure, stopping nicorandil resulted in the disappearance of the pain and a complete healing of the lesions in 6 months.

Until the health authorities or the pharmaceutical companies withdraw this drug from the market, healthcare professionals should avoid nicorandil, especially since there are a number of alternatives with a better risk-benefit balance.

©Prescrire November 2010

"Painful chronic ulceration linked with nicorandil: the vagina too" Prescrire Int 2010; 19 (110): 257. (Pdf, subscribers only).

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