Nicorandil associated anal ulceration

Objective. Nicorandil is a vasodilator used to control angina. It has been associated with oral and anal ulceration that resolves upon withdrawal of the drug. Patients and methods. We report a series of 13 patients with nonspecific anal ulceration all of whom were receiving nicorandil for control of symptoms of ischaemic heart disease. Results. All the ulcers had similar clinical and histological appearances. All the ulcers healed on withdrawal of the drug. Conclusion. Nicorandil-associated anal ulceration should be considered in the differential diagnoses of nonhealing anal ulcers.