Medicines for Treating Heart Failure
If you have heart failure, your doctor will usually prescribe some combination of medicines to help your heart work better and to ease your symptoms. In most cases, you'll need to take heart failure medication for the rest of your life, even if you start feeling better.
Heart failure medicines only work if you take them as your doctor advises. Stopping your medication at any point, not filling your prescriptions, or taking more or less of your prescribed dosage will increase the risk that your heart failure will worsen. You should also call your doctor promptly if any side effects occur.
The most common medications prescribed for heart failure patients are listed below:
- ACE (angiotensin-converting enzyme) inhibitors. Most heart failure patients are prescribed some type of ACE inhibitor. These medicines lower blood pressure and expand blood vessels so the blood can flow through more easily. That, in turn, reduces the strain on your heart. ACE inhibitors may ease your symptoms so you can be more active without feeling winded or worn out too quickly. They also may reduce your risk of death and hospitalization. ACE inhibitors make some people feel dizzy. Your doctor may suggest starting with a lower dosage or taking your ACE inhibitor at different times of the day if this is a problem. Other side effects may include persistent cough, skin rashes, and a changed sense of taste.
- Diuretics (water or fluid pills). These help reduce excess salt in your body, fluid buildup in your lungs, and swelling in your feet, legs, and elsewhere. They can make your heart's job easier since there's less fluid to pump throughout your body. When you take diuretics, your doctor may ask you to weigh yourself daily to make sure the medicine is removing the right amount of fluid. If you gain or lose more than a few pounds quickly, your doctor may want to adjust the dosage of your diuretic medication. Many people prefer taking diuretics in the morning so the urge to urinate doesn't interrupt their sleep at night.
- Beta-blockers. These slow your heart rate and lower your blood pressure to ease the workload on your heart. In most cases, beta-blockers are recommended for patients with all stages of heart failure, unless their condition requires hospitalization. Because beta-blockers lower the amount of oxygen in your body, they make some people feel tired. Other possible side effects include blood pressure that is too low and worsening of asthma symptoms.
- Digoxin. This helps your heart beat stronger and pump more blood. It can also help slow down some abnormally fast heartbeats. Digoxin must be taken in the right amount, so your doctor will want to monitor your reaction to it. Too much digoxin may cause a loss of appetite, nausea or vomiting, and headaches. Sometimes it can also cause an irregular heartbeat.
Other medications prescribed for heart failure patients include:
- Angiotensin II receptor blockers (ARBs). ARBs "block" the effect of angiotensin II. Angiotensin II can tighten blood vessels and increase blood pressure and heart strain. ARBs may be an alternative for people who can't tolerate ACE inhibitors.
- Blood thinners. Some heart failure patients may be at risk for blood clots. These drugs are used to prevent them and the risk of stroke they cause. Side effects can include easy bruising and nosebleeds.
Other Treatment Options
Sometimes surgery is done to fix a correctable cause of heart failure, such as a blocked artery or a defective heart valve.
Hospitalization or surgery may also be needed when heart failure progresses to the point that medicine and healthier lifestyle habits are not enough to keep symptoms from getting worse and becoming potentially life-threatening.
Information for Patients about BiDil®
BiDil is approved for use with other heart medicines to treat heart failure in black patients to improve survival, improve heart failure symptoms, and help patients stay out of the hospital longer. There is little experience in patients with heart failure who experience significant symptoms while at rest. Most patients in the clinical study of BiDil also received other heart failure medicines.
IMPORTANT SAFETY INFORMATION
Tell your doctor about any allergies you have, especially if you're sensitive to nitrates, such as nitroglycerin tablets or isosorbide dinitrate (Isordil®). BiDil has a nitrate component, so you need to let your doctor know.
WARNINGS AND PRECAUTIONS
Tell your doctor if you're taking any erectile dysfunction or pulmonary hypertension drugs like Viagra® or Revatio™ (sildenafil), Levitra® (vardenafil) or Cialis® (tadalafil). Mixing these with BiDil may cause a sudden drop in blood pressure, fainting, chest pain, or heart attack.
Also tell your doctor if you are taking any medication to decrease blood pressure because when taken with BiDil, blood pressure may become too low.
It is possible you'll get headaches, especially at first, but they often lessen over time. For some patients, Tylenol® (acetaminophen) helps ease the discomfort. Keep your doctor posted on your headache progress and Tylenol use; he or she may want to adjust your dosage.
If you experience dizziness, call your doctor. Please make sure to tell your doctor about any of the signs or symptoms mentioned below or about any unusual events that worry you.
Drinking less fluids than your doctor recommends or losing fluid due to diarrhea, sweating, or vomiting may cause low blood pressure, lightheadedness, or fainting. If fainting occurs, stop taking BiDil and contact your doctor immediately.
Lightheadedness may occur when standing, especially after sitting or lying down.
If you experience any achy and/or swollen joints, unexplained fever for more than a few days, skin rashes, chest pain, prolonged weakness or fatigue (even after a good night's sleep), or any other unexplained signs or symptoms, make sure to tell your doctor as they may be signs of a serious medical condition.
You may also experience rapid heartbeat that could lead to chest pain or aggravate chest pain, or numbness or tingling in the hands or feet.
COMMON SIDE EFFECTS
Headache and dizziness were the most frequent side effects experienced in studies with BiDil. Other side effects included chest pain, weakness, nausea, chest infection, low blood pressure, sinusitis, palpitations, high blood sugar, runny nose, tingling, vomiting, impaired vision, high cholesterol, and rapid heart rate.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please click here to see full Prescribing Information for BiDil. This information does not take the place of talking with your healthcare provider about your condition or your treatment. Ask your doctor if BiDil may be right for you.
Isordil is a registered trademark of Biovail Laboratories International SRL; Viagra is a registered trademark and Revatio is a trademark of Pfizer Inc.; Levitra is a registered trademark of Bayer Aktiengesellschaft and is used under license by GlaxoSmithKline; Cialis is a registered trademark of Eli Lilly and Company; Tylenol is a registered trademark of McNEIL-PPC, Inc.