Persistent orocutaneous and anal fistulae induced by nicorandil: a case report

Goh, Cyndi; Wong, Sally Cy; Borland, Colin

doi:10.1186/1752-1947-3-119

Cited by 9 publications

(8 citation statements)

References 15 publications

(31 reference statements)

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“…This 10‐year survey of 148 French cases of NIU is the first available survey based on spontaneous pharmacovigilance reports of both cutaneous and mucosal lesions induced by nicorandil. During this same period, 199 other cases were reported worldwide in 61 published articles: 173 cases of mucosal lesions, 21 cases of cutaneous lesions and 5 cases of mucosal and cutaneous lesions (Table ) .…”

Section: Discussionmentioning

confidence: 98%

Nicorandil‐induced ulcerations: a 10‐year observational study of all cases spontaneously reported to the French pharmacovigilance network

Babic

Petitpain²,

Guy

et al. 2018

International Wound Journal

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Nicorandil-induced ulcers remain often poorly recognised, with a late diagnosis and an inadequate management. We aimed to provide a clinical overview of the 148 spontaneously reported cases of nicorandil-induced ulcers to the French pharmacovigilance network between 2005 and 2014 and to complete this picture with worldwide published cases over the same period. Spontaneously reported nicorandil-induced ulcers were mainly mucosal (oral and anal) with a previous trauma in 23·0% of patients, revealed by a severe complication in 12·8% of cases. The mean cumulative dose of nicorandil was higher in serious cases. The median delay between the start of nicorandil use and the onset of the ulcer was 23·4 months, and after the ulcer was diagnosed, the median time to incriminate nicorandil was still 3·3 months, being shorter for mucosal ulcerations than for cutaneous ulcerations (5·2 versus 14·0 months, P = 0·001). The anatomic distribution in the 199 published cases differed slightly, but delays were similar. The hypothesis of mechanism becomes more precise, leaving no doubt about the necessity to discontinue the treatment. Practitioners need to be aware that nicorandil-induced ulcers can occur in many locations, possibly multiple and complicated, and should be simply managed by discontinuing treatment with no further reintroduction of nicorandil.

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Section: Discussionmentioning

confidence: 98%

Nicorandil‐induced ulcerations: a 10‐year observational study of all cases spontaneously reported to the French pharmacovigilance network

Babic

Petitpain²,

Guy

et al. 2018

International Wound Journal

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“…Les lésions du tractus digestif peuvent être responsables d'hémorragies, fistules et perforations, complications graves, nécessitant une prise en charge urgente et adéquate. Parfois, les ulcérations buccales sont concomitantes avec les lésions extra-orales [27].…”

Section: Discussionunclassified

Démarche diagnostique devant une ulcération linguale unique. Cas clinique et revue de la littérature

Radoï

Renoux

2016

Med Buccale Chir Buccale

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Résumé -Introduction :Les ulcérations des muqueuses buccales peuvent être dues à une cause locale mais également être la manifestation de certaines pathologies générales ou de leurs thérapeutiques. Des maladies infectieuses, dermatologiques, hématologiques, carentielles, malignes et la prise de certains médicaments sont susceptibles de provoquer des ulcérations buccales, d'évolution aiguë ou chronique. De nombreux médicaments peuvent induire des ulcérations buccales, associées ou non à d'autres atteintes, cutanées et/ou muqueuses. Observation : Une patiente de 85 ans consultait pour une ulcération linguale évoluant depuis 5 semaines. Ce travail présente la démarche diagnostique qui a permis d'aboutir au diagnostic d'ulcération d'origine médicamenteuse liée à la prise de nicorandil. Discussion : Devant une ulcération muqueuse, l'anamnèse et l'examen clinique orientent le diagnostic. Les examens complémentaires permettent de retenir la cause médicamenteuse, après l'exclusion des autres étiologies possibles. La démarche diagnostique peut s'avérer difficile, notamment chez les patients qui souffrent de nombreuses pathologies et sont polymédiqués. Conclusion : L'implication du nicorandil dans la survenue d'ulcérations buccales ou extra-buccales est mal connue par les praticiens, ce qui explique le retard dans le diagnostic et la prise en charge adaptée des patients.Abstract -Diagnostic approach to a single chronic ulcer of the tongue. Case report and literature review.

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“…Healing after cessation of therapy usually takes 5–6 weeks. Occasionally the ulcers may progress to fistulas . Rarely‐life‐threatening perianal hemorrhage may occur .…”

Section: To the Editormentioning

confidence: 99%

Nicorandil and Its Associated Gastrointestinal Side Effects

Kapoor¹

2013

Pacing Clinical Electrophis

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Persistent orocutaneous and anal fistulae induced by nicorandil: a case report

Cited by 9 publications

References 15 publications

Nicorandil‐induced ulcerations: a 10‐year observational study of all cases spontaneously reported to the French pharmacovigilance network

Nicorandil‐induced ulcerations: a 10‐year observational study of all cases spontaneously reported to the French pharmacovigilance network

Démarche diagnostique devant une ulcération linguale unique. Cas clinique et revue de la littérature

Nicorandil and Its Associated Gastrointestinal Side Effects

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