Medications for Heart Attack
Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these drugs as advised by your doctor or the booklet they came with. If you have any questions, call your doctor.
Treatment with medicine starts on the way to the hospital and continues after you get home. They are used to open blood vessels and prevent blood clots, and treat high blood pressure or cholesterol. The medicines used will change over time depending on your needs.
Prescription Medicine
- Morphine
- Dilaudid
- Fentanyl
- Nitroglycerin
- Tissue plasminogen activator (tPA)
- Streptokinase
- Reteplase
- Tenecteplase
- Lanoteplase
Angiotensin-converting enzyme (ACE Inhibitors)
- Enalapril
- Lisinopril
- Quinapril
Angiotensin II Receptor Blockers (ARBs)
- Candesartan
- Irbesartan
- Losartan
- Valsartan
- Ticlopidine
- Clopidogrel
- Prasugrel
- Heparin
- Warfarin
- Bivalirudin
- Atorvastatin
- Pravastatin
- Lovastatin
- Simvastatin
- Fluvastatin
- Rosuvastatin
Over-the-Counter Medicine
Prescription Medicine
Opioids
Common names:
- Morphine
- Dilaudid
- Fentanyl
Opioids are are used to ease pain and anxiety.
Possible problems are:
- Constipation
- Nausea and vomiting
- Itching
- Lightheadedness
- Sedation
Nitrates
Nitroglycerin
Nitrates ease chest pain by widening the arteries. This lets more blood to flow to the heart muscle. There are many ways to take nitrates.
Possible problems are:
- Low blood pressure
- Headache
Thrombolytic Agents
Common names:
- Tissue plasminogen activator (tPA)
- Streptokinase
- Reteplase
- Tenecteplase
- Lanoteplase
These will break up blood clots in the arteries of the heart to improve blood flow.
Possible problems are:
- Stroke
- Hemorrhage
Heart Rhythm
These drugs help regulate heart rhythm so the blood can get to the heart muscle.
Sodium Channel Blockers
Common names:
- Procainamide
- Quinidine
- Disopyramide
- Lidocaine
- Flecainide
- Tocainide
- Amiodarone
- Mexiletine
- Propafenone
- Moricizine
Beta-blockers
Common names:
- Acebutolol
- Atenolol
- Betaxolol
- Metoprolol
- Nadolol
- Pindolol
- Propranolol
- Timolol
- Carvedilol
- Nebivolol
Beta-blockers ease the heart's workload and lowers blood pressure. They can also be used to regulate heart rhythm.
Possible problems are:
- Low blood pressure
- Slow heart rate
- Fatigue
- Problems having sex
ACE Inhibitors
Common names:
- Enalapril
- Lisinopril
- Quinapril
ACE inhibitors lower blood pressure. They can also extend life in those with severe heart damage.
Possible problems are:
- Lasting dry, unproductive cough
- Low blood pressure
- Headache
- Lightheadedness
- Swelling
- Skin rashes
ARBs
Common names:
- Candesartan
- Irbesartan
- Losartan
- Valsartan
Possible problems are:
- Headache
- Lightheadedness
- Nasal congestion
- Back and leg pain
- Diarrhea
Antiplatelet Drugs
Common names:
- Ticlopidine
- Clopidogrel
- Prasugrel
These drugs help keep the blood from clotting. They may be given when aspirin cannot be used. They may also be given with aspirin to people who have had an angioplasty.
Possible problems are:
- Bleeding
- Diarrhea
- Stomach upset
Anticoagulants
Common names:
- Heparin
- Warfarin
- Bivalirudin
Anticoagulants help to keep the blood from clotting. It is often given to people during heart procedures or after other clot-busting drug treatment.
Possible problems are:
- Internal bleeding
- Stroke
Statins
Common names:
- Atorvastatin
- Pravastatin
- Lovastatin
- Simvastatin
- Fluvastatin
- Rosuvastatin
Statins lower cholesterol levels in the blood. Atorvastatin may reduce the risk of repeat stroke or heart attack. These drugs may be used with other methods to treat high cholesterol such as changes in how you eat.
Possible problems are:
- Headache
- Muscle pain
- Liver damage—rare
Over-the-Counter Medications
Special Considerations
If you are taking medicine:
- Take medicine as directed. Do not change the amount or the schedule.
- Ask what side effects could occur. Report them to your doctor.
- Talk to your doctor before you stop taking any prescription medicine.
- Do not share your prescription medicine.
- Medicine can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
- Plan for refills as needed.
REFERENCES:
Acute coronary syndromes. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116779/Acute-coronary-syndromes. Updated March 15, 2019. Accessed March 27, 2019.
Acute myocardial infarction (MI). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/acute-myocardial-infarction-mi. Updated December 2018. Accessed March 27, 2019.
Cardiac medications. American Heart Association website. Available at: https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications. Accessed March 27, 2019.
Hypertension medication selection and management. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T114476/Hypertension-medication-selection-and-management. Updated November 16, 2018. Accessed March 27, 2019.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI. Updated July 10, 2018. Accessed March 27, 2019.
Statins. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T116844/Statins. Updated April 5, 2018. Accessed March 27, 2019.
Last reviewed March 2019 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 3/27/2019