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- W2088891415 abstract "Conflicts of interest: none declared. Sir, Nicorandil is a vasodilator used to control angina by decreasing cardiac preload and afterload. Since our initial case report in 1997 of nicorandil‐induced major aphthous stomatitis,1 many authors have described single and multiple localizations of similar nicorandil‐induced ulcerations in anal, perianal, vulval, perivulval, intestinal, colonic and peristomal locations. Cutaneous ulcerations have recently been reported, sometimes even at a distance from mucosal ulcerations, and the theoretical link between fistulating bowel disease and nicorandil therapy is currently being investigated.2 3–4 Today, the mechanism of these adverse drug reactions remains unknown but is thought to involve the toxicity of the drug or its metabolites as well as vascular steal phenomenon in vulnerable sites.2 The hypothetical interaction between the metabolic pathways of nicorandil and the endogenous pool of nicotinamide adenine dinucleotide/phosphate (NAD/NADP) is proposed here for the first time. Nicotinamide and nicotinic acid, also called niacin, vitamin B3 or vitamin PP (pellagra preventing), are naturally occurring water‐soluble substances widely distributed in human tissues. The daily requirement ranges from 15 to 20 mg, and they originate mainly from yeast, meat, fish, potatoes, green vegetables and wholemeal cereals. Nicotinic acid is also synthesized from dietary tryptophan, via vitamin B6 coenzyme. Both nicotinamide and nicotinic acid belong to the endogenous pool of NAD/NADP derivatives.5" @default.
- W2088891415 created "2016-06-24" @default.
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- W2088891415 date "2008-05-01" @default.
- W2088891415 modified "2023-10-02" @default.
- W2088891415 title "Nicorandil and ulcerations: a NAD/NADP and nicotinic acid-dependent side-effect?" @default.
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- W2088891415 doi "https://doi.org/10.1111/j.1365-2133.2008.08490.x" @default.
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