Nicorandil
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Peristomal ulcer in an elderly patient: case report A 71-year-old woman developed a peristomal ulcer during long-term treatment with nicorandil for unstable angina. The woman had a history of severe ischaemic heart disease and nicorandil was started in 1999 [dosage and route, not stated]. She was also receiving numerous other cardiac drugs. Five years prior to presentation, she had undergone a Hartmann’s procedure for a vesicocolic fistula. She presented with a tender area bordering her colostomy [time to reaction onset not stated]. Despite the application of a variety of dressings during the following 2 weeks, ulceration occurred. Over the following 3 months the ulcer progressively worsened. Nicorandil was withdrawn immediately after it was identified as a possible cause of ulceration. The ulcer improved within 1 week and slight granulation was observed. Four weeks after withdrawal of nicorandil, almost complete resolution was evident. Author comment: "Interestingly, it is possible that the vesicocolic fistula , for which the Hartmann’s procedure was performed, may have been as a result of Nicorandil." Kidd L, et al. Letter: Nicorandil-induced peristomal ulceration. International Wound Journal 7: e541, No. 6, Dec 2010. Available from: URL: http:// 803048211 dx.doi.org/10.1111/j.1742-481x.2010.00720.x - United Kingdom
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Reactions 22 Jan 2011 No. 1335
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