Medication · antianginal

Supplements and Nicorandil.

Every documented pair, every citation. Below: 2 documented pairs grouped by mechanism.

Nicorandil, sold under the brand name Ikorel, is classified under "antianginal" in the BNF.

Nicorandil (UK brand names Ikorel) sits at NHSBSA prescribing rank 156 in the 2024/25 PCA statistics. The BNF classifies it under "antianginal". This means it sits outside the high-volume therapeutic classes (statins, PPIs, ACE inhibitors, SSRIs) where supplement-interaction surfaces are densely studied, and the published evidence base for specific supplement pairs is correspondingly thinner. Where interactions are documented in the Distil database, they are listed below with their clinical-reference citation; where pairs have not been explicitly assessed, the missing-item form at the bottom of the page routes them into our next curation pass. Anyone combining Nicorandil with a regular supplement stack benefits from explicit GP or pharmacist awareness rather than assuming no interaction exists by default.

Below are the 2 documented pairs we have explicitly assessed against Nicorandil in the Distil database: 2 amber. The pairs cluster around 1 mechanism: Additive vasodilation. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

Additive vasodilation

Amber Beetroot Extract

Nicorandil is an anti-anginal medicine that widens blood vessels partly by acting as a nitrate, releasing nitric oxide. Beetroot acts on the same nitric oxide pathway by a different route. Taken together the blood-pressure-lowering effects can add up, so you may notice more dizziness, lightheadedness or a headache. The combined effect tends to be mild, but tell your GP or cardiologist you take beetroot and keep your intake steady.

PMID 25421976 · PMID 35369064 · PMID 37244392 · BNF: Nicorandil

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Amber L-Citrulline

Nicorandil is an anti-anginal medicine that widens blood vessels partly by acting as a nitrate, releasing nitric oxide. L-citrulline raises nitric oxide by a different route, by feeding the arginine pathway. Taken together the blood-pressure-lowering effects can add up, so you may notice more dizziness, lightheadedness or a headache. The combined effect tends to be mild, but tell your GP or cardiologist you take citrulline and keep your dose steady.

PMID 30029482 · PMID 31336573 · PMID 40789388 · BNF: Nicorandil

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.