Medications - Your Heart Medication

pills iconThe medication your doctor has prescribed is designed to control your symptoms and improve the efficiency of your heart. Here are some tips to help ensure you stick to your schedule:

  1. Always take your medication, even if you feel well.
  2. Take your medications at the same times every day – make it part of your daily routine.
  3. Never change or stop taking your drugs before asking your doctor about it.
  4. Your doctor may modify the dose of your medications slightly, depending on what is best for you.
  5. Have all your prescriptions filled at the same pharmacy – that way, your pharmacist will get to know you and your medical history, and can counsel you appropriately.
Medication Action Side effects Recommendations

Angiotensin converting enzyme (ACE) inhibitors

Also called:
• Captopril (Capoten)
• Enalapril (Vasotec)
• Cilazapril (Inhibace)
• Lisinopril (Prinivil or Zestril)
• Quinapril (Accupril)
• Ramipril (Altace)*
• Fosinopril (Monopril)*
• Trandolapril (Mavik)*
• Perindopril (Coversyl)*
• Benazepril (Lotensin)*
• Moexipril (Univasc)*

• Widens (dilate) blood vessels.
• Reduces the work of your heart.
• Controls blood pressure.

• Weakness.
• Dizziness.
• Dry cough.
• Itchy skin or rash.
• Diarrhea.
• Rarely, swelling of your face, tongue, hands or feet (call your doctor immediately if this happens).

• Take this medication at the same time each day.
• To reduce the risk of dizziness, get up slowly from a sitting or lying position and avoid stressful exercise.
• Avoid drinking alcohol, as it may lead to dizziness.

Angiotensin II receptor antagonists*

Also called:
• Candesartan (Atacand)
• Eprosartan (Teveten)
• Irbesartan (Avapro)
• Losartan (Cozaar)
• Telmisartan (Micardis)
• Valsartan (Diovan)

• Widens (dilate) blood vessels.
• Reduces the work of your heart.
• Controls blood pressure.

• Weakness.
• Dizziness.
• Itchy skin or rash.
• Rarely, swelling of your face, tongue, hands or feet (call your doctor immediately if this happens).

• Take this medication at the same time each day.
• To reduce the risk of dizziness, get up slowly from a sitting or lying position and avoid stressful exercise.
• Avoid drinking alcohol, as it may lead to dizziness.

Beta-blockers

Also called:
• Carvedilol (Coreg)
• Metoprolol (Betaloc, Lopresor, Toprol XL*)
• Atenolol (Tenormin)
• Bucindolol (Bextra)*
Bisoprolol (Monocor)*

• Slows heart rate.
• Improves heart function.
• Reduces the work your heart does.

• Weakness, tiredness.
• Dizziness, lightheadedness.
• Temporary worsening of shortness of breath or fluid retention.
• Slow heart rate.

• Take this medication at the same time every day.
• Take this medication at least 2 hours before you have taken your ACE inhibitor.
• Doses are often started very low, and are gradually increased over a period of 1-3 months, so remember that your dosage will change.
• In the morning, take this medication with food.
• In the evening, take this medication right after dinner, not before you go to bed.

Diuretics

Also called:
• Furosemide (Lasix, Apo-Furosemide, Furoside, Novosemide)
• Metolazone (Zaroxolyn)
• Hydrochlorothiazide (HydroDIURIL, Moduret)
• Spironolactone (Aldactone)
• Bumetanide (Bumex)*
• Chlorothiazide (Diuril)*
• Torsemide (Demadex)*
• Triamterene (Dyrenium)*
• Dyazide*

• Eliminates water and salt (sodium) from your body.
• Prevents or reduces shortness of breath, swelling and bloating.

• Frequent urination.
• Weakness.
• Dizziness.
• Muscle cramps/spasms.
• Nausea.
• Depression.
• Loss of potassium, which may cause: dry mouth, increased thirst, irregular heartbeat, muscle cramps, weakness, fatigue.

• Take this medication with meals to avoid stomach upset.
• Take your last dose before 5:00 p.m., to prevent having to get up in the night to urinate.
• Metolazone is usually given with furosemide for maximum effect.

Digitalis/digoxin

Also called:
• Lanoxin
• NovoDigoxin

• Increases the strength and efficiency of your heart’s pumping action.
• May regulate your heartbeat.

• Nausea.
• Vomiting.
• Diarrhea.
• Major loss of appetite.
• Weakness.
• Blurred vision.
• Yellow, green or white halo around objects.

• Take this medication on an empty stomach.
• Never change brands or take extra pills.

Nitrates/nitroglycerin & vasodilators*

Also called:
• (Nitrong, Nitrogard-SR)
• Hydralazine (Apresoline)
• Isosorbide dinitrate (Isordil)

• Expands your blood vessels, making your heart pump more easily.

• Fluid retention.

• Take this medication with liquid at mealtimes.

Anticoagulants & antiplatelets*

Also called:
• Warfarin sodium (Coumadin)
• Aspirin (acetylsalicylic acid)
• ASA
• Ticlopidine (Ticlid)*
• Clopidogrel (Plavix)*
• Heparin

• Thins your blood to prevent clots from forming.

• Hemorrhaging (bleeding), which may result in feelings such as headache, chest, abdomen or joint pain, dizziness, shortness of breath, difficulty breathing or swallowing, swelling, or weakness.

• Take your dose as soon as possible on the same day if you’ve forgotten, but don’t take a double dose the next day to make up for missed doses.

Inotropic agents

Also called:*
• Amrinone (Inocor)
• Milrinone (Primacor)
• Dobutamine (Dobutrex)
• Dopamine (Intropin)
• Isoproterenol (Isuprel)

• Helps your heart pump more effectively.

• Nausea, vomiting.

• Inotropic agents are administered intravenously while you are in hospital.

Calcium channel blockers*

Also called:
• Amlodipine (Norvasc)

• Used to treat the high blood pressure often associated with heart failure.

• headaches, facial flushing and dizziness, ankle swelling.

• These medications are not used often to treat heart failure.
• Side effects generally disappear with continued treatment.

Potassium*

• Since most diuretics remove potassium from the body, heart failure patients who use them are at risk of losing too much potassium. Some patients need to take potassium supplements or pills to compensate for the amount they're losing.

• ACE inhibitors can actually cause the body to retain potassium, so this needs to be taken into account as well. Patients should check with their doctors to determine their potassium needs.

• Instead of potassium, sometimes all is needed to do is eat foods high in potassium, such as bananas.
• The doctor will do blood tests to check on potassium level and kidney function.

*Draft changes pending adoption by CHFN
Adopted from Medications Commonly Used to Treat Heart Failure, American Heart Association