Prescrire Int. 2008 Jun;17(95):110-1.
(1) Nicorandil is a vasodilator with limited efficacy, marketed for symptomatic relief of angina pectoris. Oral ulcerations, sometimes quite large, are an adverse effect of nicorandil that has been known since the 1990s. Cases of painful anal ulceration were reported later. (2) More recently, it has emerged that nicorandil can also cause very painful chronic ulceration of the colon and small intestine. Painful parastomal ulceration has also been reported in patients with ileostomies or colectomies. (3) Gastrointestinal ulceration has been reported from the mouth to the perineum. It is sometimes associated with skin ulcers. (4) In some cases the lesions are sufficiently extensive and refractory to warrant surgery (colostomy) or immunosuppressant treatment. However, simply withdrawing nicorandil generally leads to recovery with a few weeks. (5) Nicorandil should not be considered a standard treatment for angina pectoris. It is better to choose another drug such as a betablocker. Nicorandil must be withdrawn if cutaneous or gastrointestinal ulceration occurs.
(1) 尼可地尔是一种疗效有限的血管扩张剂，用于缓解心绞痛症状。口腔溃疡，有时相当大，是自20世纪90年代以来就已知的尼可地尔的一种不良反应。后来有报道出现疼痛性肛门溃疡的病例。(2) 最近发现，尼可地尔还可导致结肠和小肠非常疼痛的慢性溃疡。回肠造口术或结肠切除术患者也有疼痛性造口旁溃疡的报道。(3) 从口腔到会阴均有胃肠道溃疡的报道。有时还伴有皮肤溃疡。(4) 在某些情况下，病变范围足够广泛且难以治愈，需要进行手术（结肠造口术）或免疫抑制治疗。然而，单纯停用尼可地尔通常会在几周内康复。(5) 尼可地尔不应被视为心绞痛的标准治疗药物。最好选择另一种药物，如β受体阻滞剂。如果发生皮肤或胃肠道溃疡，必须停用尼可地尔。
