Carl R. Darnall Army Medical Center - Health Library

Medications for Heart Failure

Medicine for heart failure can help to decrease workload on the heart. It may also help your heart work better. The type of medicine will depend on your needs and overall health.

Ask your doctor about any special steps you may need. Follow any instructions from your doctor. Talk to your doctor if you have any questions about medicine use or side effects.

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 can affect fluid levels in your body. It encourages the passing of water and sodium from the body. You may have heard them referred to as water pills. They are used to treat heart failure and high blood pressure.

Possible general side effects include:

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

Aldosterone Receptor Blocker (MRAs)

Common names include eplerenone

MRAs are used to treat high blood pressure. It may be used in people who have heart failure after a 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 help to relax blood vessels and lower blood pressure. This can ease the workload on the heart. It can decrease symptoms and prolong life in people with heart failure.

Possible general side effects include:

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

Vasodilators

Common names include:

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

Heart failure often leads to tightened blood vessels. It increases blood pressure and workload of the heart. Vasodilators help to open blood vessels. This will lower blood pressure and decrease stress on the heart.

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

ARBs are similar to ACE inhibitors. However, they don’t cause cough as much as ACE. ARBs can have very rare, but severe side effects. ACE inhibitors may be used along with ARBs in some with severe heart failure.

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 to slow the heart rate and reduce blood pressure. They are used for mild to moderate heart failure. They are often used along with other medicine.

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 (Digitalis)

Common names include:

  • Digoxin
  • Digitoxin

Digoxin increases the strength of the heart and slows the heartbeat. This helps the heart pump out more blood with less stress, Digoxin can also control abnormal heart rhythms.

Possible side effects include:

  • Nausea
  • Vomiting
  • Confusion

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the 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.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medicine with anyone.
  • Medicines can be dangerous when mixed. Talk to your doctor if you are taking more than one medicine. This includes over-the-counter products and supplements.

Note: NSAIDs, such as ibuprofen and naproxen, can make your condition worse. Talk to your doctor about other medicine that is safe.

REFERENCES:

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 with reduced ejection fraction. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114099/Heart-failure-with-reduced-ejection-fraction. Updated August 16, 2016. Accessed October 3, 2016.

Heart failure medications. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/PreventionTreatmentofHeartFailure/Heart-Failure-Medications_UCM_306342_Article.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 Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905359/Choosing-Wisely: Choosing wisely. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T905359/Choosing-Wisely. Updated July 23, 2015. Accessed September 20, 2016.

Last reviewed August 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 8/17/2018