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Heart Failure

Medication For Heart Failure

Last updated on:
10/04/2012

Contributing Author: Guy Slowik FRCS

Medication can do a number of things for heart failure:

  • Help the heart maintain a strong, regular heartbeat
  • Open up (dilate) the blood vessels, to reduce the heart's workload
  • Remove excess fluid from the body
  • Correct the balance of sodium and potassium in the body

Medications your doctor may prescribe for heart failure include:

  • Diuretics(water pills) remove excess fluid from the body.
  • ACE inhibitors open up (dilate) the blood vessels, making it easier for the heart to pump blood through the body.
  • Digitalis strengthens the heart's pumping action.
  • Beta blockers help reduce the workload of the heart.

Other medications may be added depending on the cause of the heart failure, such as medication to lower blood pressure.

How To Information:

Take all your medicine regularly, as prescribed, even if you feel well, or even if you don't think it is working. Complying with the medication part of your plan is essential in the overall success of treatment. Don't make any changes in the dosage unless you talk with your doctor first.

Diuretics

Most people with heart failure take diuretics, which are sometimes called "water pills." These medications work by pulling fluid out of the bloodstream and out of the tissues. The fluid is then passed out of the body in the urine.

This helps in several ways:

  • It decreases the heart's workload. With less fluid in the body, it will be easier for the heart to pump blood around the body.
  • It reduces or eliminates accumulation of fluid in legs and lungs.

Possible side effects of diuretics are:

  • Frequent urination
  • Rash
  • Potassium deficiency (you may need to take potassium supplements)

Medications To Improve Blood Flow

These medications widen the blood vessels. With wider blood vessels, the heart does not have to work so hard to push the blood through the arteries. The most widely used are the ACE inhibitors, which work by inhibiting the production of a substance called angiotensin II, which normally causes blood vessels to tighten.

Possible side effects of ACE inhibitors are:

  • Dizziness when standing up suddenly due to lowered blood pressure
  • Dry cough
  • Skin rash

ACE inhibitors and diuretics can affect the sodium and potassium levels in the blood, and may also affect kidney function. You will need regular blood tests to monitor possible changes.

Medications To Strengthen The Heartbeat

The commonly used medication digoxin strengthens the pumping action of the heart and helps maintain a regular beat.

Digoxin has been used for centuries: it is made from digitalis, which comes from the foxglove plant.

Tell your doctor if you experience these side effects from digoxin:

  • Loss of appetite
  • Nausea
  • Blurred vision
  • Heartpalpitations, a sensation that your heart is beating too fast, too slow, or irregularly

Never take more digoxin than the dose prescribed. Too much can slow down the heart.

Other Medications

Depending on what caused your heart failure, you may need additional medications such as:

  • Beta-blockers to improve the function of the left ventricle
  • Nitroglycerine to cope with pain in the chest (angina)
  • Aspirin or other medication to keep the blood from clotting
  • Medications to lower blood pressure, or control cholesterol

Nice To Know:

It's important to tell the doctor all the medication you are taking, including over-the-counter pills for colds, headaches, indigestion, etc. These may interact or interfere with your heart medication.

Need To Know:

If you are taking diuretics, you may need potassium supplements to replace possible potassium loss. ACE inhibitors, however, help preserve potassium. Potassium is essential to keep your muscles working properly. Low potassium causes the following:

  • Leg cramps
  • Heartpalpitations
  • Digestive problems, if the muscles of the digestive system cannot function properly
  • Breathing difficulties

A long-time shortage of potassium can lead to paralysis.

To prevent problems, inform your doctor immediately if you get leg cramps or feel muscle weakness. Be sure not to stop the potassium unless the doctor says you should.

Your doctor may suggest you eat more potassium-rich foods, such as bananas, melons, dried fruit, or leafy green vegetables.

 

 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.