Nicorandil associated anal ulceration

Nicorandil is a vasodilator used to control angina. It has been associated with oral ulceration and stomatitis that resolves upon withdrawal of the drug. We report a series of five patients with non-specific anal ulceration, all of whom received nicorandil for symptomatic control of ischaemic heart disease. Histological appearances were similar and the ulcers healed on withdrawal of the drug. Our results suggest that nicorandil might be a cause of anal ulceration.