Medicines for Heart Failure: Care Instructions

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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.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What medicines are used for heart failure?

  • 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. ACE inhibitors include lisinopril and captopril.
  • Angiotensin II receptor blockers (ARBs) work like ACE inhibitors. Some people use them instead. They include losartan. An ARB may be combined with another medicine in one pill.
  • Diuretics reduce swelling. They do this by helping the kidneys get rid of excess fluid. They are also called water pills.
  • Beta-blockers can slow the heart rate and decrease blood pressure. They can help heart failure. They include bisoprolol, carvedilol, and metoprolol.
  • Digoxin relieves symptoms in some people with heart failure.
  • Aspirin and other blood thinners prevent blood clots. Blood clots can cause a stroke or heart attack.

If your doctor prescribes other medicines for heart failure, you will get more details on those specific medicines.

What should you know about these medicines?

ACE inhibitors

Before you start to take an ACE inhibitor, tell your doctor if:

  • You take 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 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, tell your doctor if:

  • You take anti-inflammatory medicines such as Advil or Aleve, antacids, potassium pills or a salt substitute, or lithium.
  • You have kidney disease.
  • You take a diuretic.
  • You are pregnant or breastfeeding or are planning 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, tell your doctor 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 do not have to use the washroom at a bad time.
  • Muscle cramps. This may mean that you are losing too much potassium. It is an important mineral. Call your doctor or nurse call line if you get muscle cramps.
  • Breast tenderness. This may occur in men who take spironolactone. Call your doctor or nurse call line if you get breast tenderness that bothers you.

Beta-blockers

Before you start to take a beta-blocker, tell your doctor if:

  • You have asthma or diabetes.

Side effects include:

  • Feeling dizzy or tired. This usually gets better with time.
  • Swelling. This may occur in your face, hands, legs, and feet. Call your doctor or nurse call line if you have swelling.
  • Shortness of breath or wheezing. Call your doctor or nurse call line right away if you have either of these side effects.

Digoxin

Before you start to take digoxin, tell your doctor 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 or nurse call line right away if you have any of these side effects.

Aspirin and other blood thinners

Before you start to take aspirin or other blood thinners, tell your doctor if:

  • You have had a stroke or stomach ulcers in the past.
  • You have high blood pressure. And tell your doctor if you already take blood-thinning medicines or anti-inflammatory medicines such as Advil or Aleve.

Side effects include:

  • Upset stomach. Try to take aspirin with food.
  • Bleeding. Call your doctor or nurse call line if you have unusual bleeding. This includes having nosebleeds, large or many bruises, blood in your urine, or red or black stools.

Where can you learn more?

Go to http://www.healthwise.net/ed

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