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Heart Failure: Avoiding Medicines That Make Symptoms Worse


Some medicines can affect your heart and make your heart failure worse. Others may keep your heart failure medicines from working right. So it's important to be careful with medicines. These include NSAID pain relievers and medicines that speed up the heart rate.

Over-the-counter medicines that you may need to avoid include:

  • Pain relievers called NSAIDs. Examples are ibuprofen and naproxen.
  • Antacids or laxatives that have sodium in them.
  • Some cold, cough, influenza (flu), or sinus medicines. These include medicines that have aspirin, ibuprofen, pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline in them.
  • Natural health products. These include black cohosh, St. John's wort, and vitamin E.

Prescription medicines that you may need to avoid include:

  • Calcium channel blockers, a type of heart medicine.
  • Heart rhythm drugs that treat a fast or uneven heartbeat.
  • Prescription NSAID pain relievers.
  • Certain diabetes medicines.

How to avoid medicines that can make heart failure worse

Some medicines can make heart failure symptoms worse. Here are some tips for how to avoid them.

  • Make a list of your medicines.

    This includes prescription medicines and over-the-counter medicines. List any cold and influenza (flu) remedies, pain relievers, and stomach medicines. Include natural health products. Update your list if you start a new medicine or stop taking one.

  • Keep the list of medicines with you.

    Keep a copy in your purse or wallet. Then you'll be able to easily take the list to every doctor appointment and the drugstore. Also make sure that your partner, a family member, your caregiver, or a friend has an extra copy of your list of medicines.

  • Talk with your doctors about your medicines.

    Each time you see a doctor, make sure that they know that you take medicines for heart failure. Show the doctor your list of medicines that you take. If you get a new prescription, ask if it's safe to take with your heart failure medicines.

  • Talk with your pharmacist.

    Before you fill any new prescription, tell the pharmacist that you have heart failure. Show them your list of all the medicines you take. Ask if it's okay to take the new prescription medicine. When you buy over-the-counter medicines, ask if the medicine is safe to take. Use the same pharmacy or drugstore for all of your prescriptions.

  • Make a list of over-the-counter medicines that are okay to take.

    Ask your doctor or pharmacist to help you. This list can include common medicines such as pain relievers, cold and cough medicines, and stomach medicines. Keep your list in your purse or wallet, so you'll always have it ready. Give a copy to anyone who may buy medicines for you.

  • Do not take pain relievers called NSAIDs.

    NSAIDs include aspirin and ibuprofen, such as Advil or Motrin. And they include naproxen, such as Aleve. Use acetaminophen, such as Tylenol, instead. If your doctor has told you to take an aspirin every day for your heart, follow the instructions on how much to take. Don't use aspirin for pain.

  • Read labels, and know what ingredients to avoid.

    Do not take medicines that have pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline in them. These ingredients are found in some cough, cold, and flu medicines. Watch for all of these in allergy medicines, nose sprays, and natural health products too. Do not take medicines, such as cold medicine, that have aspirin or ibuprofen in them. Do not take medicines that contain sodium or saline, such as some antacids.

When to call a doctor

Call 911 or other emergency services right away if:

  • You have symptoms of sudden heart failure. These may include:
    • Severe trouble breathing.
    • A fast or irregular heartbeat.
    • Coughing up pink, foamy mucus.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Light-headedness or sudden weakness.
    • A fast or irregular heartbeat.
  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or changed symptoms of heart failure, such as:
    • New or increased shortness of breath.
    • New or worse swelling in your legs, ankles, or feet.
    • Sudden weight gain, such as more than 1 to 1.3 kg (2 to 3 lb) in a day or 2.3 kg (5 lb) in a week. (Your doctor may suggest a different range of weight gain.)
    • Feeling dizzy or light-headed or like you may faint.
    • Feeling so tired or weak that you cannot do your usual activities.
    • Having trouble sleeping. Shortness of breath wakes you up at night. You need extra pillows to prop yourself up.


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