MAYORANDIL 5

MAYORANDIL 5 is used for the long-term management of stable angina. Angina is chest pain, pressure or tightness that appears when the heart muscle does not receive enough oxygen-rich blood, typically during exertion, emotional stress or cold exposure. It usually happens because the coronary arteries have narrowed (coronary artery disease). Many people in India live with angina for years, and the discomfort often limits walking, climbing stairs or even daily chores.

Nicorandil is a distinctive anti-anginal because it works in two ways at once:

• Potassium-channel opening: it opens ATP-sensitive potassium channels in the smooth muscle of arteries. This relaxes the arterial walls, lowers the resistance the heart pumps against (afterload) and improves blood flow through the coronary vessels.
• Nitrate action: its nitrate component releases nitric oxide, which relaxes the veins as well. This reduces the volume of blood returning to the heart (preload), so the heart works less hard and needs less oxygen.

The result is a better balance between the oxygen the heart needs and the oxygen it receives. Nicorandil also dilates both normal and diseased coronary arteries, and its potassium-channel action is thought to have a protective effect on heart muscle cells during periods of reduced blood supply (sometimes described as ischaemic preconditioning).

Doctors in India commonly consider nicorandil when:

• angina persists despite beta-blockers, calcium channel blockers or long-acting nitrates;
• these first-line medicines cause side effects or are not tolerated; or
• an additional anti-anginal is needed alongside other cardiac medicines.

The 5 mg strength is often chosen to start therapy at a lower dose, which may help people who are sensitive to headache, the most common early side effect. The dose and duration should always be set by your cardiologist or physician after reviewing your condition, blood pressure, other medicines and kidney and liver function.

Product Information

Why Is MAYORANDIL 5 Important?

Angina is a warning sign. It tells you that the heart’s blood supply is limited, and it carries a real risk of progressing to a heart attack if the underlying disease is not managed. Controlling angina is therefore about two things: living comfortably today and protecting the heart over the long term.

MAYORANDIL 5 matters for several reasons:

1. It addresses oxygen supply and demand together. Many anti-anginals reduce the heart’s workload. Nicorandil does this and also improves coronary blood flow.
2. It does not rely on slowing the heart. Beta-blockers and some calcium channel blockers lower heart rate, which can be a problem in people with slow heart rhythms, asthma or fatigue. Nicorandil has little effect on heart rate and contractility at usual doses, so it can offer an alternative or an add-on.
3. It lowers the burden of day-to-day symptoms. Fewer angina episodes mean fewer emergency visits, less anxiety and a better ability to stay active, which is itself good for the heart.
4. There is clinical evidence behind it. In the IONA study of patients with stable angina and extra cardiovascular risk factors, nicorandil was associated with fewer major coronary events compared with placebo. Your doctor can explain how such evidence applies to your situation.
5. It suits combination treatment. Nicorandil can be used alongside other cardiac medicines under medical supervision, which helps when angina is not controlled by one drug.

Medicine is only one part of heart care. Stopping tobacco, controlling blood pressure, blood sugar and cholesterol, eating a heart-healthy diet low in salt and saturated fat, staying active as advised and managing stress all improve outcomes. Never ignore chest pain that is new, more frequent, lasts longer than usual or occurs at rest. Seek emergency care without delay.

Key Benefits 

• Relieves and prevents angina: helps reduce the frequency and severity of exertional chest pain in stable angina.
• Dual mechanism of action: the potassium-channel opening and nitrate effects together relax arteries and veins for a balanced reduction in the heart’s workload.
• Improves coronary blood flow: dilates the coronary arteries, supporting oxygen delivery to heart muscle.
• Minimal effect on heart rate and contractility: useful for patients who cannot take, or cannot tolerate, drugs that slow the heart.
• Possible heart-muscle protection: the potassium-channel action is associated with protection of heart cells during reduced blood supply.
• Better exercise tolerance: patients may be able to walk further or do more before symptoms begin.
• Does not typically cause nitrate tolerance in the same way as conventional nitrates: because of its potassium-channel action, many patients do not need a nitrate-free interval, though your doctor will advise on dosing.
• Flexible low-dose starting strength: the 5 mg tablet allows a gentler start, which can help the body adjust and may reduce the intensity of initial headaches.
• Supports combination therapy: can be used with other prescribed cardiac medicines when a single drug is not enough.
• Trusted manufacturer: made by Steris Healthcare Pvt. Ltd., a WHO-GMP and ISO-certified pharmaceutical company in Jaipur, Rajasthan.

Precautions Before and While Taking 

• Prescription only. Take it exactly as prescribed. Do not change the dose or stop it suddenly without advice.
• Not for acute attacks. MAYORANDIL 5 is for prevention and regular control. For a sudden angina attack, use the fast-acting medicine your doctor has prescribed for this purpose and seek emergency help if pain does not settle.
• Do not use if allergic to nicorandil, nitrates or any ingredient in the tablet.
• Do not take with sildenafil, tadalafil, vardenafil or riociguat. Combining nicorandil with these medicines can cause a dangerous fall in blood pressure. Tell every doctor and pharmacist that you take nicorandil.
• Avoid in certain heart and circulation conditions: tell your doctor if you have very low blood pressure, shock, low blood volume, or heart failure with low filling pressure. These are generally reasons not to use nicorandil.
• Mouth, stomach and gut ulcers: nicorandil has been linked to ulcers in the mouth, gut and anal area. Report persistent mouth sores, severe stomach pain, black stools, bleeding or pain around the anus to your doctor promptly. Treatment may need to be stopped.
• Skin and eye ulceration: rarely, skin ulcers or eye problems (red, painful or sensitive eyes, blurred vision) can occur. Seek medical advice if you notice these.
• Medicines that increase ulcer risk: corticosteroids and NSAIDs, including aspirin and diclofenac, may raise the risk of serious gut problems when taken with nicorandil. Do not self-medicate with painkillers. Your doctor will weigh risks and benefits if you need them.
• Other blood pressure medicines: antihypertensives, other vasodilators, diuretics, antidepressants and alcohol may add to the BP-lowering effect and cause dizziness.
• Potassium: nicorandil can affect potassium levels. If you take potassium supplements, potassium-sparing diuretics, ACE inhibitors, ARBs or have kidney disease, your doctor may monitor your potassium.
• Liver and kidney disease: inform your doctor so dosing and monitoring can be adjusted.
• Glaucoma: people with certain types of glaucoma should discuss risks with their doctor.
• Pregnancy and breastfeeding: use is generally avoided unless the doctor believes the benefit clearly outweighs the risk. Tell your doctor if you are pregnant, planning pregnancy or breastfeeding.
• Alcohol: may intensify dizziness and low blood pressure. Limit or avoid it.
• Driving and machinery: dizziness or headache may affect alertness, especially early in treatment. Avoid hazardous tasks until you know how you respond.
• Rise slowly from sitting or lying to reduce the chance of lightheadedness.
• Surgery: tell your surgeon and anaesthetist that you are taking nicorandil.
• Missed dose: take it when you remember unless it is almost time for the next dose. Do not double up.
• Older adults and children: older people may be more sensitive to BP changes. Safety in children has not been established.
• Storage: keep below 25 °C, in a dry place, away from light, and out of the reach of children. [PLACEHOLDER: confirm storage statement from approved label.]

Possible Side Effects 

Many people tolerate nicorandil well, and early effects often fade within the first days or weeks as the body adapts. Tell your doctor if any effect persists or bothers you.

Common side effects

• Headache (the most frequent effect, particularly when starting treatment)
• Flushing or a feeling of warmth
• Dizziness or lightheadedness
• Nausea or vomiting
• Palpitations or a feeling of a fast heartbeat
• Weakness or tiredness
• Mild fall in blood pressure

Less common side effects

• Stomach upset or abdominal discomfort
• Sweating
• Muscle pain
• Skin rash or itching
• Mouth sores or ulcers
• Rise in heart rate

Frequently Asked Questions

1. What is Nicorandil 5 mg used for?

Nicorandil 5 mg is used to prevent and manage angina, a type of chest pain caused by reduced blood flow to the heart. It helps relax blood vessels and improve blood flow to the heart muscle.

2. What is the price of Nicorandil 5 mg tablets in India?

The price of Nicorandil 5 mg tablets in India varies depending on the brand, pack size, manufacturer, and pharmacy. Contact a licensed pharmacy or pharmaceutical supplier for the latest price and availability.

3. Where can I buy Nicorandil 5 mg tablets in India?

You can purchase Nicorandil 5 mg tablets from licensed retail pharmacies or authorised online pharmacies in India, subject to availability and a valid prescription.

4. Which brands offer Nicorandil 5 mg tablets?

Nicorandil 5 mg tablets may be available under different brand names from pharmaceutical companies in India. Check the product composition, strength, manufacturer details, and current availability with a licensed pharmacist.

5. Is Nicorandil 5 mg available in tablet form?

Yes, Nicorandil 5 mg is available in tablet form. It is an oral medication prescribed for the prevention and management of angina.

6. What are the side effects of Nicorandil 5 mg?

Common side effects may include headache, dizziness, nausea, and flushing. Nicorandil can also cause serious mouth, stomach, or intestinal ulcers. Seek medical attention if you experience severe or persistent symptoms.

7. How should Nicorandil 5 mg tablets be taken?

Take Nicorandil 5 mg exactly as prescribed by your doctor. Swallow the tablet as directed, follow the recommended schedule, and do not change the dose or stop treatment without medical advice.

8. Do I need a prescription to buy Nicorandil 5 mg?

Yes, Nicorandil should be used under medical supervision and obtained with a valid prescription where required. Consult your doctor before starting treatment.

9. What is the difference between Nicorandil 5 mg and 10 mg?

The main difference is the amount of active ingredient in each tablet. Nicorandil 5 mg contains 5 mg, while Nicorandil 10 mg contains 10 mg. The appropriate strength depends on your condition and your doctor's prescription.

10. Which manufacturer supplies Nicorandil 5 mg tablets in India?

Several pharmaceutical companies may manufacture or market Nicorandil 5 mg tablets in India. Confirm the current supplier, product availability, and manufacturing details directly with an authorised pharmaceutical distributor or the relevant manufacturer.