nicorandil + atenolol

Nicorandil + atenolol is a **combination drug** composed of nicorandil, a potassium channel opener and nitrate vasodilator, and atenolol, a cardioselective beta-1 adrenergic receptor antagonist. This combination is utilized in the management of **chronic stable angina pectoris**. Nicorandil works by causing vasodilation of coronary arteries and peripheral vessels, reducing both preload and afterload, and opening ATP-sensitive potassium channels (KATP channels) in vascular smooth muscle. Atenolol reduces heart rate, contractility, and myocardial oxygen demand by antagonizing beta-1 adrenergic receptors, primarily affecting cardiac tissue. The additive effect may lead to enhanced anti-anginal efficacy through complementary mechanisms: nicorandil improves coronary blood flow and hemodynamics, while atenolol mitigates sympathetic cardiac stimulation and oxygen demand.