Table 3.

Summary of characteristics of nicorandil

Mechanism of action	Absorption	Peak dose	Half-life	Metabolism	Elimination	Prescribing considerations	Adverse effects
Nitric oxide donor	> 75% oral bioavailability	30–60 min	1–2 h	Extensive hepatic metabolism	Mainly renal	Twice-daily dosing	Hypotension   Dizziness   Headache   Vasodilation and flushing
Activates adenosine-sensitive potassium-channel (K+ATP)	Almost complete enteral absorption	Linear dose-to-plasma concentration	Mostly eliminated from plasma within 8 h	Predominantly denitration followed by subsequent nicotinamide metabolism	More than 60% of administered dose eliminated in urine 24 h after dosing	No specific dosing in the elderly or in patients with chronic renal or hepatic impairment	Weakness, nausea and vomiting, haemorrhage
	Avoids first-pass metabolism				Only 1% excreted unchanged in urine		Rarely skin, mucosal, gastro-intestinal and eye ulceration