What are the medicines for heart failure

Heart failure is a condition in which the heart cannot pump enough blood through the body. This can cause symptoms such as shortness of breath, fatigue, and confusion.

There are two types of heart failure:

• Heart failure with reduced ejection fraction. In this type, the heart muscle is weak.
• Heart failure with preserved ejection fraction. In this type, the heart muscle does not fill with blood properly and may be stiff.

There is no cure for heart failure. However, being treated with medicines and following your health care provider’s instructions about a healthy lifestyle can help you stay active, avoid problems, and live longer.

Talk to your health care provider about all medicines that you are taking, how often you should take them, and what possible problems (side effects) they may cause. Talk with your health care provider if you have difficulty affording your medicines.

What are some common medicines for heart failure?

The medicines that are prescribed for you will depend on your symptoms, the type of heart failure you have, and the cause of your heart failure. In some cases, you may need to take more than one medicine. You will be prescribed the following medicines according to your type of heart failure:

Heart failure with reduced ejection fraction

• Beta-blockers.
• Angiotensin-converting enzyme (ACE) inhibitors.
• Angiotensin II receptor blockers (ARBs).
• Angiotensin receptor neprilysin inhibitors (ARNIs).
• Aldosterone antagonists.
• Diuretics.
• Digoxin.
• Nitrates.

Heart failure with preserved ejection fraction

• Medicines to control blood pressure, including:
  • Beta-blockers.
  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Angiotensin II receptor blockers (ARBs).
• Diuretics.
• Aldosterone antagonists.

What should I know about beta-blockers?

• These medicines lower your blood pressure and slow your heart rate. This helps to lessen your heart’s workload.
• They can help to relieve chest pain (angina).
• They can help to improve your heart’s ability to pump.
• They may cause asthma attacks and shortness of breath.
• Because these medicines slow your heart rate, it is important not to overwork yourself while exercising. Talk to your health care provider about what your target heart rate should be while you exercise.
• These medicines can hide the symptoms of low blood sugar (glucose), which is also called hypoglycemia. If you have diabetes, make sure to check your blood glucose carefully. If you have hypoglycemia, talk to your health care provider about adjusting your medicines.
• Beta-blockers may make you feel dizzy or light-headed at first. Do not drive or use heavy machinery when you first start these medicines. Ask your health care provider when it is safe for you to drive.

What should I know about ACE inhibitors or ARBs?

• These medicines help to widen arteries and veins. This action lowers your blood pressure and lessens the strain on your heart, making it easier for your heart to pump.
• They can help to lessen the symptoms of heart failure.
• ARBs are often used if a person cannot take ACE inhibitors.
• ACE inhibitors may cause a dry cough.
• In rare cases, ACE inhibitors and ARBs can cause swelling of the tongue or lips, other swelling, taste problems, and skin rashes. If these symptoms occur, stop taking the medicines and contact your health care provider.
• Do not take ACE inhibitors if you are pregnant or may become pregnant. These medicines can cause health problems in an unborn baby.
• These medicines may cause dizziness. You may need regular checkups and blood tests to monitor how they are working.

What should I know about ARNIs?

• These medicines are a combination of an ARB and another medicine. They lower your blood pressure.
• Side effects may include dry cough, dizziness, low blood pressure, and kidney problems.
• Do not take ARNIs if you are already taking ACE inhibitors or ARBs.
• You may notice increased urination when taking these medicines.
• ARNIs can raise the amount of potassium in the blood. Your potassium levels will be monitored regularly by your health care provider.

What should I know about aldosterone antagonists?

• They help the body to remove excess sodium through urination. This helps to lessen the amount of blood that the heart needs to pump.
• They can also help to lower blood pressure and improve the heart’s ability to pump blood.
• They may cause dizziness, diarrhea, coughing, or flu-like symptoms.
• They should not be used if you have type 2 diabetes.
• They can raise the amount of potassium in the blood. Your potassium levels will be monitored regularly by your health care provider.
• These medicines can make men’s breasts large and tender.

What should I know about diuretics?

• Diuretics are medicines that help the body get rid of excess fluid through urination. They can also help lessen your heart’s workload.
• They help to lessen fluid buildup in the lungs, ankles, and feet.
• They help to lower your blood pressure.
• They can worsen problems with controlling urination (urinary incontinence).
• They may cause dizziness, headaches, muscle cramps, and an upset stomach.
• They can cause weak muscles, dry mouth, or confusion. It is important to drink plenty of fluids while taking these medicines, especially while exercising or on hot days.

What should I know about digoxin?

• Digoxin helps the heart pump more blood efficiently. It also lowers your heart rate.
• It can help ease heart failure symptoms and may be used if other medicines do not work.
• It can also help with irregular heartbeat (arrhythmia).
• It may cause stomach problems, fatigue, headache, drowsiness, or vision problems.

What should I know about nitrates?

• Nitrates relax the blood vessels and increase oxygen and blood supply to the heart. They also lower the blood pressure.
• They are usually taken to lessen chest pain.
• They may cause headaches, flushing, or irregular heartbeat.

Summary

• A healthy lifestyle and treatment with medicine will relieve symptoms of heart failure.
• In some cases, you may need to take more than one medicine.
• It is important to talk to your health care provider about how often you should take your medicines. Do not skip a dose or change your dosage.
• Talk to your health care provider about possible side effects of these medicines.