Nicorandil
Nicorandil produces arterial and venous dilation by opening potassium channels in vascular smooth muscle, and by its nitrate properties. It is used for the prevention and treatment of stable angina.
Headache is a common adverse effect, particularly on initiation of therapy, and can be severe. It is a dose-related effect and, similar to the headaches with other nitrates, generally resolves with continued treatment. While evidence suggests tolerance develops to the nitrate component, there is a relative lack of haemodynamic tolerance, which is probably due to potassium channel activation.
Sildenafil, tadalafil and vardenafil should not be used concomitantly with nicorandil, because of its nitrate moiety.
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