Nicorandil


  Issues for Surgery


Risk of worsening angina if omitted.

Risk of gastrointestinal (GI) side effects if continued.


  Advice in the Perioperative period


Elective and Emergency Surgery

Continue.

Post-operative Advice

Restart post-operatively as soon as next dose is due.


  Interaction(s) with Common Anaesthetic Agents


None1, 2, 3, 4.


  Interaction(s) with other Common Medicines used in the Perioperative Period


Gastrointestinal (GI) Side Effects

Concomitant use of nicorandil and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) or corticosteroids may increase the risk of GI ulceration, perforation and haemorrhage – caution is advised with concurrent use and monitor for adverse GI effects2, 3, 4. Particular care should be taken in patients taking other drugs known to have adverse GI effects i.e. selective serotonin re-uptake inhibitors (SSRIs)2.


  Further Information


None relevant.

 

  References


  1. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 5th May 2019]
  2. Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 5th May 2019]
  3. Nicorandil. In: Brayfield A (Ed), Martindale: The Complete Drug Reference. London: The Royal Pharmaceutical Society of Great Britain. http://www.medicinescomplete.com [Accessed 5th May 2019]
  4. Summary of Product Characteristics – Nicorandil 10mg Tablets. Rivapharm UK Ltd. Accessed via www.medicines.org.uk 05/05/2019 [date of revision of the text February 2018]