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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

The following medications may be used to treat heart failure.

Prescription Medications

Diuretics

  • Hydrochlorothiazide
  • Chlorothiazide
  • Metolazone
  • Furosemide
  • Bumetanide
  • Triamterene
  • Spironolactone
  • Torsemide
  • Indapamide
  • Polythiazide
  • Amiloride
  • Combination agents

Aldosterone receptor blocker

  • Eplerenone

Angiotensin-converting enzyme inhibitors (ACE inhibitors)

  • Captopril
  • Enalapril
  • Lisinopril
  • Benazepril
  • Quinapril
  • Ramipril
  • Fosinopril
  • Moexipril
  • Trandolapril
  • Perindopril

Vasodilators

  • Isosorbide dinitrate
  • Nesiritide
  • Hydralazine
  • Nitrate drugs
  • Minoxidil

Angiotensin II receptor blockers (ARBs)

  • Losartan
  • Irbesartan
  • Valsartan
  • Candesartan
  • Eprosartan
  • Telmisartan
  • Olmesartan

Beta-blockers

  • Metoprolol
  • Atenolol
  • Carvedilol
  • Bisoprolol
  • Propranolol
  • Sotalol
  • Pindolol
  • Penbutolol
  • Acebutolol
  • Timolol
  • Nadolol
  • Betaxolol

Digoxin

  • Digoxin
  • Digitoxin

Prescription Medications

Diuretics

Common names include:

  • Hydrochlorothiazide
  • Chlorothiazide
  • Metolazone
  • Furosemide
  • Bumetanide
  • Triamterene
  • Spironolactone
  • Torsemide
  • Indapamide
  • Polythiazide
  • Amiloride
  • Combination agents

Diuretics help promote excretion of water and sodium from the body. You may have heard them referred to as water pills. This reduces the amount of work the heart has to perform.

Possible general side effects include:

  • Altered potassium levels, which can cause muscle cramping and abnormal heart rhythms
  • Low blood pressure
  • Lightheadedness
Aldosterone Receptor Blocker

Common names include eplerenone

Aldosterone receptor blockers are generally used to treat high blood pressure. The drug may be used to treat people who develop heart failure following an acute heart attack.

Possible general side effects include:

  • Headache
  • Lightheadedness
  • Abdominal pain
  • Diarrhea
  • Cough
  • Fatigue
  • Flu-like symptoms
  • Breast enlargement or tenderness
Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors)

Common names include:

  • Captopril
  • Enalapril
  • Lisinopril
  • Benazepril
  • Quinapril
  • Ramipril
  • Fosinopril
  • Moexipril
  • Trandolapril
  • Perindopril

ACE inhibitors prevent the body from creating angiotensin II, a substance in the blood that causes vessels to tighten and raises blood pressure. As a result, ACE inhibitors relax blood vessels, lower blood pressure, and ease the heart’s workload. A number of studies have shown that ACE inhibitors are beneficial in reducing symptoms and prolonging life in people with heart failure. These medications are often considered in all people with heart failure.

Possible general side effects include:

  • Cough and occasional rash
  • Altered sense of taste
  • Increased potassium levels, altered kidney function

Common names include:

  • Isosorbide dinitrate
  • Nesiritide
  • Hydralazine
  • Nitrate drugs
  • Minoxidil

Vasodilators help dilate or enlarge blood vessels. People with heart failure often have blood vessels that are constricted, which causes the heart to work harder pumping blood through the vessels. Vasodilators address this problem.

Possible general side effects include:

  • Sudden drop in blood pressure
  • Lightheadedness, which can lead to fainting
  • Headache
  • Flushing
  • Racing heart or palpitations
Angiotensin II Receptor Blockers (ARBs)

Common names include:

  • Losartan
  • Irbesartan
  • Valsartan
  • Candesartan
  • Eprosartan
  • Telmisartan
  • Olmesartan

These are a newer class of medications similar to ACE inhibitors, but with a significantly lower frequency of cough as a side effect. The general side effects in angiotensin II receptor blockers were similar to that of placebos in most studies. Like ACE inhibitors, they may have very rare, but severe side effects. In selected groups of people with severe heart failure, ACE inhibitors may be used along with ARBs.

Possible side effects:

  • Upper respiratory infections
  • Lightheadedness
  • Nasal congestion
  • Muscle cramps
  • Back pain
Beta-Blockers

Common names include:

  • Metoprolol
  • Atenolol
  • Carvedilol
  • Bisoprolol
  • Propranolol
  • Sotalol
  • Pindolol
  • Penbutolol
  • Acebutolol
  • Timolol
  • Nadolol
  • Betaxolol

Beta-blockers help slow the heart rate and reduce blood pressure. They are used for mild-to-moderate heart failure and are often used in conjunction with other medications such as diuretics, ACE inhibitors, and digoxin.

Possible side effects:

  • Decreased sexual ability
  • Trouble sleeping
  • Unusual tiredness or weakness
  • Low blood pressure, which can make you feel tired, lightheaded, or faint
  • Decreased ability to participate in strenuous physical activity
Digoxin

Common names include:

  • Digoxin
  • Digitoxin

Also known as digitalis, this medication increases the strength of the heart contractions, slows the heartbeat, and controls abnormal heart rhythms, such as atrial fibrillation.

Possible side effects include:

  • Nausea
  • Vomiting
  • Confusion

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking any prescription medications without talking to your doctor.
  • Do not share the prescription medications.
  • Know what the results and side effects may be. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

Note: Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can worsen your condition. Talk to your doctor about other medications you may be able to take.

Revision Information

  • ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;119(14):1977-2016.

  • Flather MD, Yusuf S, et al. Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. ACE-Inhibitor Myocardial Infarction Collaborative Group. Lancet. 2000;355:1575

  • Heart failure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 20, 2013. Accessed October 9, 2013.

  • Heart failure medications. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Heart-Failure-Medications%5FUCM%5F306342%5FArticle.jsp. Updated October 12, 2012. Accessed October 9, 2013.

  • How is heart failure treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/hf/treatment.html. Updated January 9, 2012. Accessed October 9, 2013.

  • 4/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Choosing wisely. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed April 2, 2014.