Common Heart Failure Medications
Heart failure medications are designed to reduce fatigue, shortness of
breath and tissue swelling. Medications can help prevent or slow down
the progression of the disease, enabling people with heart failure to
live longer and more comfortably.
When starting on new cardiac medications, it is not uncommon for patients
to experience dizziness when standing up too quickly. This is an adjustment
period and usually lasts for a few days or up to a week. It is important
to get up slowly from a sitting position, allowing blood pressure to stabilize.
Your doctor will recommend the best treatment plan for you.
Angiotensin-Converting Enzyme Inhibitors (ACEI)
This is a medication that blocks the action of an enzyme that causes blood
vessels to narrow. This results in a reduction of the heart’s workload,
lower blood pressure and reduced swelling. Notify your doctor if you experience
swelling of the face or tongue, or experience a persistent, dry, hacking cough.
- benazepril (Lotensin)
- captopril (Capoten)
- enalapril (Vasotec)
- fosinopril (Monopril)
- lisinopril (Prinvil, Zestril)
- quinapril (Accupril)
- ramipril (Altace)
Angiotensin Receptor Blockers (ARB’s)
These medications also block the action of chemicals that narrow blood
vessels and may be prescribed for patients who cannot tolerate an ACE
inhibitor.
- valsartan (Diovan)
- losartan (Cozaar)
- irbesartan (Avapro)
- azilisartan (Edarbi)
- candesartan (Atacand)
- telmisartan (Micardis)
Angiotensin Receptor-Neprilysin Inhibitor (ARNI)
This medication contains two medications that work in different ways to
counteract the effects of heart failure. Valsartan is the first medication
(see ARB’s). The second medication, sacubitril, inhibits an enzyme
and helps to relax blood vessels and lower sodium and fluid.
- sacubitril/valsartan (Entresto)
Beta-Blockers
Beta blockers slow heart rate, and reduce blood pressure – allowing
the heart to decrease its workload – and reverse remodeling.
- carvedilol (Coreg)*
- nebivolol (Bystolic)*
- metoprolol succinate (Toprol XL)*
- metoprolol tartrate (Lopressor)
- atenolol (Tenormin)
- acebutolol (Sectra)
- bisoprolol (Zebeta)
- labetalol (Trandate)
*Recommended for heart failure
Aldosterone Antagonists
These are potassium-sparing medications that block the hormone aldosterone
and help rid the body of extra fluid, reduce swelling, lower blood pressure
and improve breathing.
- spironolactone (Aldactone)
- epleronone (Inspira)
Vasodilators
These medications widen blood vessels, lower blood pressure and allow more
blood to reach the heart muscle. They may be combined with other medications
to treat heart failure.
- isosorbide mononitrate (Imdur)
- isosorbide dinitrate (Iso-Bid, Isordil)
- hydralazine (Apresoline)
- hydralazine and isosorbide dinitrate (Bidil)
Diuretics
These medications act on the kidneys to rid the body of excess salt and
water. They reduce the accumulation of fluid in the legs, abdomen, and
lungs, lower blood pressure, and improve the efficiency of the circulation.
LOOP DIURETICS
- furosemide (Lasix)
- torsemide (Demadex)
- bumetanide (Bumex)
- ethacrynic acid (Edecrin)
POTASSIUM SPARING DIURETICS
- spironolactone (Aldactone)
- epleronone (Inspra)
THIAZIDE DIURETICS
- hydrochorothiazide (HCTZ, HydroDiuril)
- metolazone (Zarozolyn)
- chlorthalidone (Hygroton)
Take your diuretic in the morning to avoid waking at night to urinate.
If your diuretic is on a twice-a-day schedule, the last dose should be
taken no later than 3 p.m. Diuretics may also cause dry mouth and over-the-counter
products such as Biotene may help.
Anti-Arrhythmic medications
These medications treat irregular heartbeat conditions such as atrial fibrillation
or certain types of ventricular arrhythmias, which may help to improve
heart function over time.Used to reduce heart rate in atrial fibrillation.
- amiodarone (Cordarone, Pacerone)
- sotalol (Betapace, Betapace AF)
Calcium-Channel Blockers
These medications produce relaxation of the coronary vascular smooth muscle
by blocking the movement of calcium ions into heart cells and blood vessels.
DIHYDROPYRIDINES
- amlodipine (Norvasc)
- felodipine (Plendil)
NON-DIHYDROPYRIDINES
- verapamil (CalaR, Isoptin, Covera-HS, Verelan)
- diltiazem (Cardizem CD, Tiazac, Diltia XT)
Others
IVABRADINE (COLANOR)
This medication works by reducing heart rate and is only indicated for
patients with a regular heart beat and those who cannot take beta blockers
or are on maximum dose beta blockers.
DIGOXIN
This medication increases the force of the heart’s contraction which
increases the amount of blood that is pumped with each heartbeat. It can
help control heart rate in atrial fibrillation.
ALPHA BLOCKERS
These medications work by keeping the hormone norepinephrine from tightening
the muscles in the walls of smaller arteries and veins, which causes the
vessels to remain open and relaxed.
- doxazosin (Cardura)
- prazaosin (Minipress)
- terazosin (Hytrin)
ANTICOAGULANTS
These medications are used to help prevent and treat blood clots that can
occur in patients with a heart valve replacement, or in patients with
an irregular, rapid heartbeat called atrial fibrillation.
- Vitamin K Antagonists
- warfarin (Coumadin)
- Direct Thrombin Inhibitors
- dabigatran (Pradaxa)
- Factor Xa Inhibitors
- apixaban (Eliquis)
- rivaroxaban (Xarelto)
- edoxaban (Savaysa)
PLATELET ADP-RECEPTOR BLOCKERS
This group of medications is used after stents are placed.
- clopidogrel (Plavix)
- ticogrelor (Brilinta)
- prasugrel (Effient)
CHOLESTEROL LOWERING MEDICATIONS
Statins
These medications reduce the amount of cholesterol in the blood by blocking
the enzyme in the liver that promotes the production of cholesterol.
- atorvastatin (Lipitor)
- fluvastatin (Lescol)
- lovastatin (Mevacor)
- pravastatin (Pravachol)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
- Other Cholesterol Lowering Medications
- ezetimibe (Zetia)
- fenofibrates (Antara, Lipfen, Lofibra, TriCor, Triglide)
- omega-3-acid ethyl esters (Lovaza, Vescepa)
What You Should Know
- Take your medication as prescribed at the same time every day. Do not stop
taking your medication unless directed by your doctor.
- AVOID all Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) such as Naproxen/Aleve,
Ibuprofen/Advil or Motrin, as they can cause heart failure symptoms to worsen.
- Refill your prescription before you run out. Remember to have enough medication
with you if you are traveling.
- Know what to do in case you miss a dose of medication.Check with your doctor
or pharmacist instead of skipping a day or taking an extra dose.
- Check with your doctor before taking any over-the-counter medications,
nutritional supplements or herbal therapies.
- Antacids or sodium-based products such as Alka Seltzer may contain products
that can decrease the effectiveness of your medications.
- Erectile dysfunction medications combined with any nitrate can lead to
dangerously low blood pressure and death.
-
Studies have shown that for patients with an ejection fraction of less
than 40% the use of an Ace Inhibitor, ARB, or ARNI and a beta blocker
is beneficial for the following reasons:
- Helps control symptoms
- Helps keep you out of the hospital
- Helps prolong your life