Nicorandil can induce severe oral ulceration.
OBJECTIVE: To increase physicians' and dentists' awareness that nicorandil is a potential inducer of severe mouth ulceration. STUDY DESIGN: Nine new cases of ulceration from 3 European countries were included in this study. RESULTS: Oral ulceration developed within 9 months of beginning nicorandil therapy, and ulcers resolved within 1 month of withdrawal of the drug. No lesions developed on other epithelia. CONCLUSIONS: A number of drugs used in the care of patients with cardiovascular disease can cause oral adverse effects. Nicorandil, a new potassium-channel activator used in some countries to treat angina pectoris, precipitates persistent ulcerative stomatitis in some patients.