There are many drugs prescribed for heart disease. It's important for people with heart disease and those who care for them to understand the meds, follow the labels, and recognize possible side effects.
The ones most people with heart disease are given by their doctor include:
ACE inhibitors: These widen arteries to lower your blood pressure and make it easier for your heart to pump blood.
Aldosterone inhibitors:Eplerenone (Inspra) and spironolactone (Aldactone) are part of a class of medicine called potassium-sparing diuretics. They can ease the swelling and water buildup heart disease can cause. They help the kidneys send unneeded water and salt from your tissues and blood into your urine to be released.
These drugs may help some symptoms, even while you take other treatments. They protect your heart by blocking a chemical in your body called aldosterone that causes salt and fluid buildup.
This medicine is for folks with some types of severe heart failure.
Angiotensin II receptor blockers (ARBs): These are used to lower blood pressure for people with heart failure. They help keep your blood vessels as wide as possible so blood can flow through your body more easily. They also lessen salt and fluid buildup in your body.
Beta-blockers: They block the effects of adrenaline (epinephrine). This helps your heart work better. These meds also drop production of harmful substances your body makes in response to heart failure. And they cause your heart to beat slower and with less force. Those both lower your blood pressure.
Calcium channel blockers: These treat chest pain (your doctor may say “angina”) and high blood pressure. They relax blood vessels and increase blood and oxygen to your heart. That eases its workload. They’re used only when other medicines to lower blood pressure don’t work. Ask your doctor if one is right for you.
Cholesterol-lowering drugs:Cholesterol helps your body build new cells, insulate nerves, and make hormones. But inflammation may force cholesterol to build up in the walls of your arteries. That buildup increases your chance of having a heart attack or stroke.
Some people’s genetics make it more likely that they’ll have high cholesterol. These folks may need drug therapy, like statins, in addition to a healthier diet, to lower the chance that they'll get hardening of the arteries (also called atherosclerosis).
Digoxin: It helps an injured or weakened heart to send blood through the body and work more efficiently. It strengthens the force of the heart muscle's contractions. It may improve blood circulation.
You may be prescribed this if you have an irregular heartbeat (your doctor may call this atrial fibrillation, or AFib). It may help slow down your heart rate.
Diuretics: You may know these as water pills. They help your kidneys get rid of unneeded water and salt from your tissues and bloodstream. That makes it easier for your heart to pump. They treat high blood pressure and ease swelling and water buildup caused by some medical problems, including heart failure. They also help make breathing easier.
Inotropic therapy: This helps make an injured or weakened heart pump harder to send blood through the body. Administered through IV, it helps strengthen the heart muscle's contractions. It also relaxes constricted blood vessels so blood can flow more smoothly. Inotropic therapy may also speed up your heart's rhythm.
You may get this if you have end-stage heart failure to help relieve and control your symptoms. These medicines are used only when others have stopped working on symptoms.
Potassium or magnesium: You can lose these electrolytes when you pee more while you take diuretics. That loss can cause abnormal heart rhythms. Ask your doctor if you should take supplements to make up the difference.
Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors: You may get this new class of cholesterol-lowering drugs if diet and statin treatments aren’t helping. They block a liver protein called PCSK9. That protein hinders your liver’s ability to get rid of LDL (bad) cholesterol.
Vasodilators: These relax your blood vessels so blood can flow more easily through your body. You’ll get these if you can’t take ACE inhibitors.
Warfarin: This helps prevent clots from forming in your blood. You’ll get it if your body is making blood clots, or if you have a condition that helps cause them.
This medicine won’t dissolve a blood clot. Over time, the clot may dissolve on its own. Warfarin may also prevent others from forming.
Be sure to talk with your doctor if you have questions about any drugs you’re taking.
Heart Disease Drug Side Effects
Heart disease drugs that relax narrow blood vessels might make you dizzy. If that happens when you stand or get out of bed, then sit or lie down for a few minutes. This helps raise your blood pressure. When you’re ready, get up more slowly.
ACE inhibitors may make you cough. Let your doctor know if that keeps you up at night or gets in the way of your daily activities.
Diuretics (water pills) make you pee more. If you need a single dose each day, take it in the morning. Or if you take two doses a day, take the second one in the late afternoon. That way, you won't need to pee so often during the night, so you can sleep better.
Diuretics can make you dehydrated. Watch out for problems like:
- Extreme thirst
- Dry mouth
- Peeing less
- Dark-colored urine
Call your doctor if you have any of these. Don't just assume that you need more fluids.
Bleeding is the most common side effect if you take blood thinners. Call your doctor right away if you have:
- Heavy bleeding during your period
- Red or brown pee
- Tar-like stools
- Bleeding from your gums or nose that doesn't stop right away
- Red things you cough up
- Severe headache or stomachache
- Unusual bruising
- Cuts that won't stop bleeding
- A bump on the head or serious fall
A daily aspirin routine could increase your risk of a bleeding stroke. It also ups your chances of a stomach ulcer. You also shouldn't take aspirin if you're allergic to it.
Talk to your doctor before starting an aspirin routine.
Keeping Track of Your Heart Disease Drugs
Make sure to take the prescribed dose at the prescribed time, and get refills before they run out.
If you’re caring for a loved one with heart disease, you may need to remind them when it's time to take drugs, or you may need to give out the medication when it's time to be taken.
- Know the names, dosages, and side effects of your heart medications and what they are used for.
- Always keep a list of the medications with you so that ALL your doctors know exactly what you are taking.
- Heart medications need to be taken as scheduled, at the same time every day. Medications should not be stopped or changed without first consulting with your doctor. Continue taking a heart drug even if you feel better; stopping medications suddenly can make your condition worse.
- Develop a routine for taking your heart drugs. Get a pillbox that is marked with the days of the week, and fill the pillbox at the beginning of each week. This is an easy way to tell when each day's medications have been taken.
- If a dose is missed, take it as soon as you remember to take it. However, if it is almost time for the next dose, ask your doctor about skipping versus making up the missed dose. Two doses should never be taken to make up for the dose missed; nor should they be taken if you don't feel well.
- Make sure prescriptions are filled regularly, and if you have questions, write them down and ask the pharmacist. Don't wait until you're completely out of medication before filling prescriptions.
- Use one pharmacist to fill your prescriptions. That way, you can make sure you don't get medications that counteract each other.
- Don't take less heart medication than your doctor prescribes in order to save money. You have to take the full amount in order to get the full benefits. If medication costs are too high, talk with your doctor about ways to reduce the costs.
- Don't take any over-the-counter medications or herbal therapies until you've talked with your doctor or pharmacist. These drugs can make heart disease symptoms worse or change the effect of prescribed medications. Even common drugs such as antacids, salt substitutes, cough/cold/allergy medications, and nonsteroidal anti-inflammatory drugs (NSAIDs) can worsen heart disease symptoms or cause harmful effects when taken with some heart medicines.
- Don't store medications in the bathroom or where they are exposed to light. Moisture and heat can destroy their effectiveness.
- If you're going to have surgery, including dental surgery, tell your doctor or dentist what heart medications you're taking.
- Keep heart medications with you when traveling. Don't pack them in luggage that you don't plan to keep with you at all times; luggage that is checked can be lost or delayed in getting to you.
- Keep a separate list of all the medications you're taking, along with your doctor's phone number, dosing intervals, and dosage sizes -- in case you lose your medications.
- If you are taking a flight that crosses time zones, make sure you maintain the right dosing frequency.
- If you're taking a long trip, pack an extra week's supply of medications, the phone number of your pharmacy, and your prescriptions' refill numbers in case you need a refill.