Medicines for heart failure

ACE inhibitors and ARBs

• These medicines help lower blood pressure by opening up blood vessels and reducing the workload on the heart.
• They make it easier for your heart to work as a pump and can slow worsening of heart failure.
• You may take either an ACE inhibitor or an ARB, but never both at the same time.
• Examples of ACE inhibitors (also called angiotensin converting enzyme inhibitors) are lisinopril, perindopril, quinapril and ramipril.
• Examples of ARBs (also called angiotensin receptor blockers) are candesartan and losartan.

Sacubitril/valsartan (Entresto)

• This is a combination medicine that replaces an ACE inhibitor or ARB. It helps blood vessels open, reduces fluid buildup and eases strain on the heart.
• It belongs to a group of medicines called angiotensin receptor neprilysin inhibitors (ARNIs).
• Learn more about Entresto.

Beta blockers

• They help improve the heart pump function by preventing the heart from beating too quickly and forcefully.
• Examples are bisoprolol, carvedilol and metoprolol.

Mineralocorticoid receptor antagonists (also called aldosterone antagonists)

• These medicines help the heart work better and can lower blood pressure, even if your blood pressure is normal or you don’t have extra fluid.
• They block aldosterone, a hormone that can make the body retain salt and water. By doing this, they help the heart work more efficiently and reduce the chance of hospital visits.
• Examples include spironolactone and eplerenone.

Empagliflozin

• It helps the heart work better and reduces heart failure symptoms.
• It can also lower blood pressure and support weight management. Some people also take it for diabetes control and/or to reduce their risk of heart attack,
• Learn more about empagliflozin.

Diuretics (also called water pills)

• They help the body get rid of extra fluid and sodium, reducing swelling and making breathing easier and easing the heart’s workload.
• Examples are furosemide, bumetanide, bendroflumethiazide and chlortalidone.
• Different diuretics remove fluid at different rates and through different methods.

Digoxin

• Digoxin is used to treat abnormal heart rhythms (arrhythmias), including atrial fibrillation, by slowing your heart rate.
• This helps to reduce the strain on your heart. Digoxin also increases the force of your heart's contractions, which can be helpful if you have heart failure.
• Read more about digoxin.

Know how to manage your medicines

When you start heart failure medicines, your healthcare provider may adjust the doses and schedule to find what works best for you. Often you may need to take several medicines at the same time to help your heart work better and prevent complications.

• Know the dose, timing, and how often to take each medicine.
• Keep an updated list of your medicines and follow the instructions carefully to stay on track.
• Use a pill organizer, chart, or phone reminders to track each dose.
• Ask questions if you’re unsure why you’re taking a medicine or notice side effects.
• Don't start, stop, or change a dose on your own. Always check with your healthcare provider first.

Tell your healthcare team about everything you take

Many heart failure medicines can interact with other medicines and products, including over-the-counter medicines, supplements, and herbal products. Always let your healthcare team know everything you use so your treatment stays safe and effective. Bring your medicine list to every appointment. This helps your healthcare team adjust your treatment safely and effectively.

Avoid taking NSAIDs (such as ibuprofen, diclofenac or naproxen)

Do not take NSAIDs unless your healthcare provider says it’s safe. These medicines can:

• cause fluid buildup
• raise blood pressure
• affect your heart and kidneys
• interact with some heart failure medicines.
  
  

Always make sure you have an ongoing supply of your heart failure medicines

Heart failure symptoms can worsen if you miss doses often or run out of your medicines. Always make sure you have enough on hand and check your repeats in advance, especially before public holidays or weekends, so you don’t run out.