Your Care Instructions

Most people with heart failure benefit from taking several medicines to protect their heart. These medicines can help you feel better and live longer. It is important to take all your medicines exactly as directed to get the best results. Medicines can cause side effects. But most people feel better if they take their medicines.

If you think that any of your medicines are causing side effects, talk with your doctor.

What medicines are used for heart failure?

• Aldosterone receptor antagonists. These are a type of diuretic. They make the kidneys get rid of extra fluid.
• Angiotensin-converting enzyme (ACE) inhibitors help blood flow. They relax the blood vessels and lower your blood pressure. The heart can then pump more blood through your body without working harder.
• Angiotensin II receptor blockers (ARBs) work like ACE inhibitors. Some people use them instead.
• Angiotensin receptor neprilysin inhibitor (ARNI) medicine works like ARBs and ACE inhibitors. Some people take an ARNI medicine instead.
• Beta-blockers can slow the heart rate and decrease blood pressure.
• Digoxin relieves symptoms in some people with heart failure.
• Diuretics reduce swelling. They do this by helping the kidneys get rid of excess fluid. They are also called water pills.
• Hydralazine. This may be taken with a nitrate to widen blood vessels. It can lower blood pressure and reduce the workload on the heart.
• Ivabradine slows the heart rate.
• SGLT2 inhibitors help remove extra glucose through the urine.

What should you know about these medicines?

This is not a complete list of medicines used for heart failure. If you have questions about your medicine, ask your doctor or pharmacist.

ACE inhibitors

Before you start to take an ACE inhibitor, talk to your doctor. Tell him or her if:

• You take any anti-inflammatory medicines. These include ibuprofen (Advil, Motrin) and naproxen (Aleve).
• You take antacids, potassium pills or a salt substitute, or lithium.
• You take a diuretic.
• You are pregnant or breastfeeding or you plan to get pregnant.
• You have kidney disease.

Side effects include:

• A dry cough. If the cough is bad enough to make you stop the medicine, talk to your doctor. You may need to take a different one.
• Feeling light-headed. This may happen when you stand up too fast. It usually gets better with time.

Angiotensin II receptor blockers (ARBs)

Before you start to take an ARB, talk to your doctor. Tell him or her if:

• You take any anti-inflammatory medicines. These include ibuprofen (Advil, Motrin) and naproxen (Aleve).
• You take antacids, potassium pills or a salt substitute, or lithium.
• You have kidney disease.
• You take a diuretic.
• You are pregnant or breastfeeding or you plan to get pregnant.

Side effects include:

• Feeling light-headed or dizzy. These are the most common side effects.

Angiotensin receptor neprilysin inhibitor (ARNI)

Before you start to take an ARNI, talk to your doctor. Tell him or her if:

• You take any anti-inflammatory medicines. These include ibuprofen (Advil, Motrin) and naproxen (Aleve).
• You take antacids, potassium pills or a salt substitute, or lithium.
• You take an ACE inhibitor or an ARB.
• You have kidney or liver problems.
• You take a diuretic.
• You are pregnant or breastfeeding or you plan to get pregnant.

Side effects include:

• Feeling light-headed or dizzy. These are the most common side effects.

Diuretics (water pills)

Before you start to take a diuretic, talk to your doctor. Tell him or her if:

• You take lithium or anti-inflammatory medicines such as Advil or Aleve.

Side effects include:

• Urinating often. Ask your doctor about timing these pills so that you don't have to use the bathroom at a bad time.
• Muscle cramps. This may mean that you are losing too much potassium. It is an important mineral. Call your doctor if you get muscle cramps.
• Tender breasts. This may occur in men who take spironolactone. Call your doctor if you get tender breasts that bother you.

Beta-blockers

Before you start to take a beta-blocker, talk to your doctor. Tell him or her if:

• You have asthma or diabetes.

Side effects include:

• Feeling dizzy or tired. This usually gets better with time.

Digoxin

Before you start to take digoxin, talk to your doctor. Tell him or her if:

• You have kidney disease.
• You take a diuretic or other medicines. This includes over-the-counter medicines.

Side effects include:

• Nausea or vomiting.
• Confusion, changes in vision, a racing or slowed heartbeat, or dizziness. Call your doctor right away if you have any of these side effects.