Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Nicorandil-induced severe oral ulcerationA newly recognized drug reaction☆,☆☆
Section snippets
Case 1
A 74-year-old man was referred with a recent history of severe, persistent, large oral ulcers. He had had minor recurrent aphthous stomatitis for most of his life, but during the preceding 2 years he had developed severe recurrent ulcers, each approximately 1 cm in diameter; these ulcers occurred only on his tongue and lasted several weeks before healing. Treatment had included topical and systemic corticosteroids. The patient was extensively investigated to exclude hematologic and
DISCUSSION
Each of the 3 patients manifested severe oral ulceration, which in each case appeared for the first time after the patient’s Nicorandil therapy. The ulcers began within 3 months of the beginning of nicorandil therapy, and no local, systemic, or other cause for ulceration was detected in any of the cases. It has been suggested in other reports that a minimum dose of nicorandil of 30 mg per day is necessary to induce mouth ulcers4; 2 of the patients in this report were taking 30 mg twice a day.
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Giant buccal aphthosis caused by nicorandil
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Cited by (50)
Vitamin B12 for Relieving Pain in Aphthous Ulcers
2017, Nutritional Modulators of Pain in the Aging PopulationOral ulcerations due to drug medications
2014, Japanese Dental Science ReviewCitation Excerpt :Adverse effects of nicorandil therapy may include cutaneous vasodilatation, nausea and vomiting, dizziness, myalgia and rash. Over the past few years, cases in which nicorandil has caused oral ulceration have been reported [30–35]. Low-dose methotrexate (MTX): MTX is an antifolic agent with a well-established history of use in the treatment of various neoplastic diseases.
Oral ulceration due to a dipeptidyl peptidase-4 inhibitor (sitagliptin): Report of a case
2013, Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyCitation Excerpt :A wide spectrum of drugs can give rise to various adverse oral manifestations, particularly dry mouth, taste disturbances, lichenoid changes and oral ulceration [3]. Recently, several reports have described oral ulceration associated with relatively new drugs such as nicorandil [4–6], low-dose methotrexate [7,8] and bisphosphonate [9,10]. We report a case of oral ulceration due to a dipeptidyl peptidase (DPP)-4 inhibitor (sitagliptin) which was developed as a pharmacotherapy for type 2 diabetes mellitus (T2DM) [11–13].
Nicorandil-induced oral ulceration: Report of 3 cases and review of the Japanese literature
2011, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and EndodontologyCitation Excerpt :These ulcers are usually large, deep, and persistent with a well circumscribed and punched-out appearance.32 These are intensely painful and may interfere with eating and speaking and have a negative impact on the quality of life, such as weight loss,2,12 and even depression in some cases.31 Histologically, these are nonspecific ulcers, excluding malignancy, infection, and immunoallergic reaction.2,8,18,32
Oral ulcers
2005, Medicina ClinicaStudy of the viral infections and cytokines associated with recurrent aphthous ulceration
2005, Microbes and Infection
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Reprint requests:Professor Stephen Porter,Eastman Dental Institute of Oral Health Care Sciences,University of London,256, Gray’s Inn Road,London WC1 8LD,United Kingdom,www.eastman.ucl.ac.uk
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