Heart Attack Medicines: What to Know About Side Effects

Reviewed by Brunilda Nazario, MD on January 07, 2021

As you recover from a heart attack, medicine is one of the most important tools your doctor will use to help you heal.

Many different drugs protect your heart and can keep you from having another heart attack. Some prevent blood clots. Others lower blood pressure or cholesterol.

Like any drug, each medicine can cause different side effects. But no matter what, it’s important to keep taking your medicine until your doctor tells you to stop. If you know what to expect, you can be ready to talk to your doctor about a plan to take care of any side effects. That will help you keep taking your medicine and protect your heart.

ACE Inhibitors

ACE inhibitors widen your blood vessels and improve blood flow. That keeps your heart from working so hard to pump.

The most common side effect is a dry cough. Less often, these drugs cause:

  • Dizziness
  • Appetite loss
  • Tiredness
  • Headache
  • High potassium levels in the blood, which can cause heart rhythm problems

Rarely, ACE inhibitors can make your face, hands, or feet swell up. Swelling in your throat can make it hard to swallow or breathe. If that happens, call your doctor right away.

Angiotensin II Receptor Blockers (ARBs)

ARBs relax blood vessels to lower blood pressure. They also help your heart heal after a heart attack.

Possible side effects include:

  • Headache
  • Dizziness
  • Stuffy nose
  • Back and leg pain
  • Diarrhea
  • High potassium levels in the blood, which can cause heart rhythm problems
  • Swelling due to fluid buildup under the skin

While you take these drugs, you may need to avoid potassium supplements and salt substitutes, which could make the levels of potassium in your blood spike.

Antiplatelet Drugs

Aspirin is the most common example of these drugs, which prevent blood clots from forming. That’s important, since blood clots can block arteries that have been narrowed by a buildup of plaque, causing a heart attack. If you got a stent, these medicines can keep it open so blood can flow through it more easily.

Since antiplatelet drugs stop your blood from clotting, they could make you bleed more than usual. Use special care when you shave, brush your teeth, or cut your nails. Wear gloves when you work with gardening tools or other sharp instruments. Call your doctor if you have heavy bleeding, bruising, or you see blood in your vomit or poop.

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Other side effects can include:

  • Nausea
  • Belly pain
  • Diarrhea
  • Itching
  • Rash

You can prevent an upset stomach by taking your medicine with food.

Don't stop taking antiplatelet drugs if you do have side effects. Stopping could cause your stent to close up quickly and trigger another heart attack.

Beta-Blockers

These medicines lower your heart rate and blood pressure. The most common side effects are:

  • Cold hands
  • Tiredness
  • Dizziness
  • Weakness

Less common side effects include:

  • Shortness of breath
  • Trouble sleeping
  • Depression
  • Erectile dysfunction

You may not be able to take beta-blockers if you have asthma, because they can trigger severe asthma attacks. If you have diabetes, it can be harder to tell when your blood sugar has dropped too low. You may need to check your blood sugar more often than usual.

Beta-blockers can cause your HDL, or "good," cholesterol and triglyceride levels to go up slightly. Your levels should go back to normal on their own after a little while.

Blood Thinners

These drugs don't actually thin your blood. They prevent blood clots to lower your risk of a heart attack. Your doctor might called them anticoagulants.

The biggest risk with blood thinners is bleeding. While you’re on these medicines, you have to take extra care not to cut yourself. Ask your doctor about what precautions to take at home in case you hurt yourself.

Calcium Channel Blockers

Calcium makes your heart beat stronger and narrows your arteries. These medicines work by keeping calcium from entering the cells of your heart and blood vessels, so they stay relaxed.

Side effects include:

  • Tiredness
  • Dizziness
  • Fast heartbeat
  • Headache
  • Flushing
  • Swelling of the ankles and feet

Don't drink grapefruit juice if you take a calcium channel blocker, because it can alter your heart rate and blood pressure, causing side effects like headaches and dizziness. Also don't smoke, which can speed up your heart rate.

Diuretics

These pills remove extra salt and fluid from your blood to lower your blood pressure.

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Side effects from diuretics include:

  • Peeing more than usual
  • Thirst
  • Tiredness
  • Muscle cramps

Diuretics can also lower levels of potassium and other minerals in your blood. To treat this problem, get more potassium in your diet from foods like bananas, spinach, and broccoli. You can also talk to your doctor about supplements.

Nitrates

Nitrates widen blood vessels to let more blood flow to your heart. These drugs can cause side effects like:

  • Headaches
  • Flushing
  • Low blood pressure
  • Dizziness and fainting
  • Abnormal heart rhythms

Avoid drinking alcohol or taking drugs for erectile dysfunction with nitrates. The combination could make your blood pressure drop too low, along with other side effects, like dizziness or fainting.

Statins

Statins are a group of drugs that lower unhealthy LDL cholesterol levels. That helps to prevent plaque from building up in your arteries and causing another heart attack.

Some people who take statins have muscle pain. Exercise and vitamin D supplements may keep those aches away. If you still have cramps after a couple of weeks on statins, your doctor may give you a break from treatment or switch you to a different kind of statin drug.

Statins may also raise blood sugar levels, especially if yours are already higher than normal. Your doctor will weigh the benefits you could get from a statin against your risk of diabetes before they prescribe this drug for you. You may get regular blood sugar tests while you take statins.

What to Do if You Have Side Effects

If you have side effects from one of these drugs, keep taking the medicine. Stopping could raise your risk for another heart attack.

Instead, tell your doctor about any issues you have. There are many ways they can help you feel better, like changing your dose, switching you to another medicine, or giving you treatments to ease any symptoms that bother you.

WebMD Medical Reference

Sources

SOURCES:

American Heart Association: "About Heart Attacks," "Cardiac Medications."

FamilyDoctor.org: "Heart Attack: Medicines to Treat Heart Attack."

Harvard Medical School: "Managing statin muscle pain."

Heart and Stroke Foundation of Canada: "Antiplatelets," "Calcium Channel Blockers," "Nitrates (Nitroglycerin)."

Mayo Clinic: "Angiotensin II receptor blockers," "Beta blockers," "Calcium channel blockers," "Diuretics: A cause of low potassium?" "Statin side effects: Weigh the benefits and risks."

National Blood Clot Alliance: "Living Your Best Life While Taking Blood Thinners."

NephCure Kidney International: "Angiotensin II Receptor Blocker (ARBs)."

Seconds Count: "Medications After a Heart Attack."

Texas Heart Institute: "Ace Inhibitors," "Angiotensin II Receptor Blockers."

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