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Medicines to Avoid With Heart Failure: Care Instructions


Your doctor gave you medicines to help treat your heart failure. But did you know that many other medicines can make heart failure worse? Even medicines and natural health products that you buy over the counter (OTC) can harm you.

Be sure your doctor knows all of the OTC and prescription drugs you take. And don't start to take any medicine unless your doctor says it's okay.

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 advice line (811 in most provinces and territories) 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.

How can you care for yourself at home?

Over-the-counter drugs

  • Before you take any over-the-counter drug, ask your doctor or pharmacist if it's safe. This includes natural health products. Medicines to avoid include:
    • Pain relievers called NSAIDs. These include ibuprofen and naproxen. Use acetaminophen instead. For example, you can take Tylenol for pain or fever.
    • Low-dose aspirin. If your doctor has told you to take aspirin every day for your heart, follow the doctor's instructions on how much to take. Don't take aspirin for pain.
    • Antacids or laxatives. Don't take ones that have sodium in them. These include Alka-Seltzer.
    • Cold, cough, influenza (flu), or sinus medicines. Read the label. Don't take ones that have pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline in them. And make sure they don't have aspirin or ibuprofen in them. Watch for all of these in allergy medicines, nose sprays, and natural health products too.
    • Natural health products. These include black cohosh, St. John's wort, and vitamin E.

Prescription drugs

  • Each time you see a doctor, make sure he or she knows that you take drugs for heart failure. Before you fill any new prescription, ask the pharmacist if it's okay to take the new drug. Drugs that can make heart failure worse include:
    • Calcium channel blockers. These include nifedipine. If you need to take this type of drug for another health problem, your doctor will closely watch your health.
    • Heart rhythm drugs. These include disopyramide and flecainide. These can treat a fast or uneven heart rhythm.
    • Prescription NSAIDs. These include celecoxib (Celebrex) and diclofenac.
    • Certain medicines for diabetes. These include pioglitazone (Actos), rosiglitazone (Avandia), and saxagliptin (Onglyza).

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