Painful chronic ulceration linked with nicorandil: the vagina too.

Nicorandil is an antiangina drug with minor efficacy, which is known to cause painful ulceration of the gastrointestinal tract (from mouth to anus), and possibly the cornea. According to one detailed case report, a large, very painful, chronic vaginal ulceration only healed after permanent discontinuation of nicorandil. Prior to that, it had led to the patient undergoing hysterectomy and vaginal wall surgery that were ineffective. In practice, we must stop exposing patients unnecessarily to nicorandil.