Medications That Can Cause Heart Failure

Heart failure is often caused by other health problems, like heart disease or diabetes. But common medications can also bring it on.

This condition isn’t what it sounds like: Your heart doesn’t stop. It just doesn’t pump blood as well as it should. That means you may be short of breath, feel weak, and have swollen legs and feet, among other symptoms.

Some drugs and natural supplements cause or worsen heart failure because they:

  • Are toxic to your heart
  • Affect the strength of heart muscle contractions
  • Make high blood pressure worse
  • Prevent heart failure medications from working well

Prescription Drugs

People with heart failure take an average of 6.8 prescription medicines a day. The more drugs you take, the more likely you are to have a drug-drug interaction. This can put your heart at risk.

These drugs can raise your risk of heart failure or related problems:

Nonsteroidal anti-inflammatory drugs (NSAIDs). Prescription NSAIDs include diclofenac, ibuprofen, indomethacin, and ketorolac. More than 70 million prescriptions are written every year for this type of pain reliever. NSAIDs can boost heart failure odds because they make you retain water and salt, make it harder for your blood to flow, and make it tougher for diuretic drugs (often used to treat high blood pressure) to work.

Diabetes medications. Your body gets rid of metformin through your kidneys, so it isn’t a good choice if your kidneys don’t work like they should. Thiazolidinediones (pioglitazone, rosiglitazone) cause fluid retention and weight gain in people with heart failure and make people who don’t have it more likely to get it. Doctors aren’t sure why, but dipeptidyl peptidase-4 inhibitors (alogliptin, linagliptin, saxagliptin, sitagliptin) seem to send people with heart failure to the hospital. Never stop taking a medication without your doctor’s OK, though.

Blood pressure medicine. Calcium channel blockers can worsen edema or fluid that stays in your body’s tissues. Central agonists (clonidine, moxonidine) cause changes in the way your body releases hormones that affect your heart.

Other types of drugs that can bring on heart failure include:

  • Antifungal medications
  • Cancer medications
  • Stimulants
  • Antidepressants
  • Tumor necrosis factor (TNF) inhibitors

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Over-the-Counter Drugs

You may not think twice about taking over-the-counter (OTC) drugs for minor things like a headache or stuffy nose. But if you’re at risk of heart failure, or if you already have it, you might want to limit or avoid some medications.

OTC NSAIDs, just like the prescription ones, can make heart failure worse. They can even make it more likely that you’ll go to the hospital for heart failure.

Watch out for cold medicines. Some have NSAIDs like ibuprofen. Others have sodium or ingredients that can worsen your heart failure or conditions that come along with it.

Nasal decongestants often contain drugs that narrow your blood vessels. Look for the word vasoconstrictor on the label. These can cause heart problems when you take more than you should for a long time.

Ask your doctor for a list of safe OTC drugs and tips on what to look for on product labels.

Natural Supplements

There’s no government regulation of natural supplements, so you can’t always be sure the package contains what the label says it does. Some can cause serious risks, especially if you have a health condition.

That goes for vitamins, too. They seem harmless because they occur naturally in food. But in pill form, it’s a different story. More than 400 IU of vitamin E daily can increase your chances of developing heart failure.

Supplements can also interact with other drugs. One natural product may be fine for your neighbor but put your health at risk.

Tell your doctor about every natural supplement you take so you can find out the pros and cons. In the meantime:

  • Don’t take vitamins or supplements to prevent cardiovascular problems or improve heart failure symptoms.
  • Avoid products that contain ephedra (you may see ephedrine as part of their name). They affect your blood pressure and heart rate.

Avoid products that can interact with heart medications, like digoxin and blood thinners.

Work With Your Doctor

Keep everyone on your health care team in the loop about the drugs and supplements you take. This keeps your risk low. It’s also a good idea to limit any drugs or supplements you don’t need. Some tips:

  • At each doctor visit, provide a list of each drug and supplement you take. Include the dose and how often you take it.
  • Ask your doctor if there are any medications you can limit or stop taking.
  • If you have multiple doctors, ask one to be in charge of your medications. Update her when you get a new prescription or when one of your prescriptions changes. That way you’ll know about any increased heart risk before you make a medication change.
WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on July 21, 2017

Sources

SOURCES:

Mayo Clinic: “Heart Failure: Definition.”

Drug Safety: “Heart failure induced by non-cardiac drugs.”

Circulation: “Drugs That May Cause or Exacerbate Heart Failure.”

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