Generic Nicorandil (Angedil Tablet)

About Nicorandil Tablet

Nicorandil is a medication prescribed to alleviate and treat angina, a condition characterized by chest pain. Typically, it is recommended by doctors when other heart medications have proven ineffective or unsuitable for the patient. Nicorandil is available only with a prescription and is administered in the form of tablets.

Essential Information

• Nicorandil aids in reducing the risk of angina attacks by improving blood supply to the heart.
• Regular intake of nicorandil can also lower the chances of developing further heart-related conditions.
• The standard dosage involves taking nicorandil twice daily.
• Common side effects of nicorandil include headaches and a temporary feeling of confusion. These side effects are usually mild and short-lived.
• Nicorandil is also marketed under the brand name Ikorel.

Eligibility for Taking Nicorandil

Nicorandil can be taken by adults who are 18 years of age or older.

However, there are certain circumstances in which Nicorandil is not suitable. Inform your doctor if you:
• Have had an allergic reaction to nicorandil or any other medication in the past.
• Experience low blood pressure (hypotension).
• Have issues with fluid accumulation in the lungs (pulmonary edema).
• Recently had a heart attack or have been diagnosed with heart failure.
• Have low blood potassium levels and are currently taking potassium supplements.
• Have kidney problems.
• Have a hereditary condition known as glucose-6-phosphate dehydrogenase deficiency.
• Have a gastrointestinal condition that affects the colon (diverticular disease).
• Are taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or corticosteroid tablets.

Administration Instructions

It is typical to take Nicorandil twice a day, once in the morning and once in the evening.

Dosage Recommendations:

The appropriate dosage of nicorandil will depend on your specific needs. Typically, treatment begins with a daily intake of one 10 mg tablet, taken twice a day. If necessary, the dosage may be increased up to 40 mg. However, if you frequently experience headaches, your doctor may start you on a lower initial dose of 5 mg. This can be gradually increased after approximately one week.

How to Take Nicorandil:

Nicorandil tablets can be taken with or without food. Swallow the tablets whole with a glass of water. The tablets have a score line in the center, which allows for easy splitting if you have difficulty swallowing them.

What if You Forget to Take It?

If you miss a dose of Nicorandil, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose. Do not double your dose to make up for the missed one. To avoid forgetting doses, consider setting an alarm or consulting your pharmacist for strategies to help you remember to take your medication.

What if You Take an Overdose?

The amount of nicorandil that can lead to an overdose varies from person to person.

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Side Effects of Generic Nicorandil (Angedil Tablet)

Like all medications, nicorandil can cause side effects, although not everyone experiences them.

Common Side Effects:

These common side effects may occur in more than 1 in 100 people. They are generally mild and self-limiting.

If these side effects bother you or persist, consult your doctor or pharmacist:
• Headaches
• Dizziness or weakness
• Nausea and vomiting
• Flushing (redness of the skin)

Serious Side Effects:

Serious side effects are rare and occur in fewer than 1 in 100 people.

Seek immediate medical attention if you experience:
• Red, irritated, or watery eyes, as these may indicate conjunctivitis or a corneal ulcer.
• Painful sores (ulcers) on the eyes, skin, or mouth lining.
• Abdominal pain, nausea, loss of appetite, or blood in your stool, as these are signs of stomach ulcers.

These rare side effects can occur at any time. If you notice ulcers on any part of your body, discontinue nicorandil immediately. In rare cases, nicorandil may cause a serious allergic reaction (anaphylaxis). This list does not include all possible side effects of nicorandil. For a comprehensive list, refer to the leaflet provided with your medication.

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Precautions for Nicorandil (Angedil Tablet)

• Inform your doctor about any existing medical conditions: Before taking nicorandil, it is important to inform your doctor about any pre-existing medical conditions you may have, including kidney or liver problems, low blood pressure, heart rhythm disorders, history of ulcers or gastrointestinal bleeding, or any allergies to medications.
• Avoid grapefruit and grapefruit juice: Grapefruit and grapefruit juice can interact with nicorandil and increase the risk of side effects. It is recommended to avoid consuming grapefruit or grapefruit products while taking this medication.
• Use caution if you have low blood pressure: Nicorandil can lower blood pressure, which may cause dizziness or fainting, especially when standing up. If you already have low blood pressure, use Nicorandil with caution and inform your doctor.
• Take precautions while driving or operating machinery: Nicorandil may cause dizziness, weakness, or blurred vision in some individuals. If you experience these side effects, avoid driving or operating machinery until you feel alert and focused again.
• Monitor for signs of ulcers or gastrointestinal bleeding: Nicorandil can increase the risk of ulcers or gastrointestinal bleeding. If you experience symptoms such as abdominal pain, nausea, vomiting, or notice blood in your stool, seek medical attention immediately.
• Store the medication properly: Keep nicorandil tablets in their original packaging and store them at room temperature, away from moisture and heat. Follow the specific storage instructions provided by the manufacturer.
• Regular check-ups: Regularly visit your doctor for check-ups and monitoring while taking Nicorandil to ensure the medication is working effectively and to assess any potential side effects or interactions.

Pregnancy and Breastfeeding

Nicorandil is generally not recommended during pregnancy or breastfeeding due to insufficient data on its safety. If you are planning to get pregnant, currently pregnant, or breastfeeding, discuss the potential benefits and risks of taking Nicorandil with your doctor. They will be able to recommend the most appropriate treatment for you and your baby.

Generic Nicorandil (Angedil Tablet) Interactions with Other Medications

There are certain medications that may interact with nicorandil, potentially affecting its efficacy or causing an excessive lowering of blood pressure. Inform your doctor if you are taking any of the following:

• Medications for hypertension (high blood pressure)
• Antidepressants
• Muscle relaxants, such as baclofen
• Riociguat, a medication for pulmonary hypertension
• Potassium supplements or medications that increase potassium levels, including ACE inhibitors (e.g., lisinopril, ramipril) and angiotensin receptor blockers (ARB) (e.g., valsartan, losartan, candesartan)
• Medications for Parkinson's disease, such as co-carbidopa and levodopa
• Medications used for erectile dysfunction, such as sildenafil, tadalafil, vardenafil, or dapoxetine
• Steroids like prednisolone, which can increase the risk of stomach ulcers

Taking Nicorandil with Painkillers:

Nicorandil can be safely taken with paracetamol. However, avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and high-dose aspirin, as they can increase the risk of stomach ulcers. There are no known issues with taking herbal remedies and supplements alongside nicorandil.

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Frequently Asked Questions

How Does Nicorandil Work?

Nicorandil is classified as a potassium-channel activator. It works by relaxing and dilating blood vessels, thereby increasing blood and oxygen supply to the heart. This helps alleviate the chest pain associated with angina.

How Long Does Nicorandil Take to Work?

Nicorandil typically begins to take effect after approximately one hour, but it may take around 4 to 5 days for its full effects to be realized.

How Long Will I Need to Take Nicorandil?

In most cases, treatment with nicorandil is long-term and may continue indefinitely.

Is It Safe to Take Nicorandil Long-Term?

Nicorandil is generally safe for long-term use and tends to be most effective when taken over an extended period.

What Happens If I Stop Taking Nicorandil?

If you wish to discontinue nicorandil, it is important to consult your doctor. Stopping nicorandil abruptly may cause a return of angina pain. However, your doctor may prescribe an alternative medication if you are experiencing side effects. It takes approximately 2 days for nicorandil to be fully eliminated from your body after discontinuation.

How Does Nicorandil Compare to Other Heart Medications?

Nicorandil is not typically the first-choice treatment for angina. Beta-blockers (e.g., bisoprolol) and calcium channel blockers (e.g., amlodipine) are commonly used to alleviate angina symptoms. However, if these medications are ineffective or cause adverse effects, nicorandil or other alternative-line treatments may be prescribed. The effectiveness of nicorandil, ivabradine, and ranolazine can vary from person to person, and some individuals may require a combination of medications to manage their angina symptoms.

Do I Need to Stop Taking Nicorandil Before Surgery?

You can continue taking nicorandil before and after surgery without interruption.

Will Nicorandil Affect My Contraception?

Nicorandil does not interfere with any forms of contraception, including combined oral contraceptives and emergency contraception.

Will Nicorandil Affect My Fertility?

There is no conclusive evidence to suggest that nicorandil reduces fertility in men or women. If you are attempting to conceive or experiencing difficulties getting pregnant while taking Nicorandil, consult your doctor.

Can I Drink Alcohol While Taking Nicorandil?

Consuming alcohol while taking nicorandil can intensify its blood pressure-lowering effect, leading to dizziness or lightheadedness. During the initial days of nicorandil use or after a dosage adjustment, it is advisable to avoid alcohol until you understand how the medication affects you. If nicorandil causes dizziness, it is recommended to abstain from alcohol altogether.