HOME
A-Z

Heart Failure - Medication

It’s important to take heart failure medicines to maintain your health and prevent future incidents of heart failure.

Taking your heart failure medicines every day is an important part of your treatment plan. They work to prevent and relieve symptoms and may help your heart pump more effectively.

Stick To a Schedule When Taking Your Heart Failure Medication

Take Your Heart Failure Medicines as Prescribed

This is very important. Missing your heart failure medicines even for a day can cause the worsening of symptoms. Do approach your doctor or pharmacist for advice should you face any problems with the scheduling of your heart failure medicines.

Tips for Managing Heart Failure Medicines:

Never change your dosage or stop taking your heart failure medicine without first checking with your doctor or pharmacist.
Take your medicines at the same time every day according to instructions, for example, after you brush your teeth or after your breakfast.
Make a chart and check off each dose as you take it.
Place your medicines in a pillbox with a separate container for each day of the week. You can also obtain pillboxes that separate the different times of the day.
Ask a family member to remind you to take your heart failure medicines on time.
Always refill your prescriptions early – before you run out of heart failure medicines.
If you experience giddiness, stagger the dosing time of medicines at intervals of two hours. For example, if you have to take two different medicines, take the first medicine, wait for two hours before taking the second medicine.
Check with your pharmacist before taking any over-the-counter medicines, herbs or traditional medicines.

Side Effects of Heart Failure Medicines

Every medicine has potential side effects. The table of medicines in this booklet and other medication leaflets provided state some common side effects you may experience when taking heart failure medicines. This does not mean that you will definitely experience those side effects, as not everyone experiences them.

Tell your doctor or pharmacist if you experience any problems with your heart failure medicines.

Types of Heart Failure Medication

Your doctor may prescribe several different classes of medicines. Each class works differently to control your heart failure. The dosage of some medicines may be gradually increased to achieve the best effect. Speak to your doctor, nurse, pharmacist, or case/care manager to know more about your heart failure medicines.

Table of Medications Used in Treating Heart Failure

Class of Medicine

Example	Action	Common Side Effects	Important Points
ACE inhibitors	Captopril Enalapril Lisinopril Perindopril Ramipril	To maintain/improve heart function For better blood pressure control Prevent narrowing of blood vessels to allow blood to flow more easily Proven to help heart failure patients feel better and live longer	Dizziness Tiredness Dry cough Changes in taste buds (Especially with Captopril) May affect kidney function	Change position SLOWLY from lying to sitting to standing to reduce dizziness If you miss a dose, take as soon as you remember, but do not take two doses at one time The dose for this medicine is increased slowly to help prevent side effects Inform your doctor or pharmacist if you keep having a dry cough that disturbs you Blood test for kidney function will be monitored regularly
Angiotensin receptor antagonists	Candesartan Losartan Valsartan	Change position SLOWLY from lying to sitting to standing to reduce dizziness Blood test for kidney function will be monitored regularly
Beta-blockers	Bisoprolol Carvedilol Metoprolol Nebivolol	Reduce the workload and oxygen demands of the heart Reduce heart rate Proven to help heart failure patients feel better and live longer	Tiredness Slow heartbeat Dizziness Cold hands & feet Shortness of breath Wheezing Impotence	Change position SLOWLY from lying to sitting to standing to reduce dizziness Inform your doctor or pharmacist if you experience worsening symptoms and signs of heart failure (such as the feeling of breathlessness or weight increase) when starting or increasing the dose of this medicine
Diuretics (Water pills)	Frusemide Bumetanide Metolazone Hydrochlorothiazide	Remove excess salt and water from the body by increasing urine flow	Nausea Loss of potassium which may cause leg cramps, muscle weakness, dizziness or light-headedness	Frequent urination is the desired effect Take in the morning or late afternoon to avoid having to wake up often in the night to pass urine Your health care provider may prescribe potassium supplements to help replace the lost potassium.
Potassium supplements	Potassium chloride	Replace the loss of potassium (due to the effect of diuretics)	-	Prescribed only if blood potassium levels are low
Aldosterone antagonist	Spironolactone Eplerenone	Suppress hormone(aldosterone) to protect the heart Proven to help heart failure patients feel better and live longer	Breast tenderness or enlargement with Spironolactone (especially in males) May affect kidney function May cause high potassium level Dizziness	Inform your doctor or pharmacist if the side effect (such as dizziness or breast swelling/pain) occurs Avoid potassium supplements and foods containing high levels of potassium, and certain salt substitutes as instructed Check kidney function with regular blood tests
Cardiac glycosides	Digoxin	To improve the strength and pumping action of the heart To reduce heart rate especially in atrial fibrillation	If the level of Digoxin in the blood is too high, it can cause: Nausea & vomiting Diarrhoea Changes in vision	Take after meals to reduce nausea Inform your doctor or pharmacist if you have persistent vomiting, diarrhoea or changes in your vision (such as blurred vision, seeing bright spots or yellow vision)
Vasodilators	Isosorbide Dinitrate Isosorbide Mononitrate	Increase blood and oxygen supply to heart muscles Relax blood vessels to reduce blood pressure and improve the heart's efficiency	Dizziness Headache Flushing	Change position SLOWLY from lying to sitting to standing to reduce dizziness Cutting down on the amount of salt you take in and lifting up your legs may help to improve leg swelling.
Hydralazine	Palpitations Flushing Dizziness Leg swelling
Sinus Node Inhibitor	Ivabradine	Slows down heart rate, allowing the heart to pump more effectively	Headache See unusual or glowing lights Blurred vision	Inform your doctor or pharmacist if changes in vision occur
Antiplatelets/Anticoagulants (Blood thinners)	Aspirin	Prevents the formation of blood clots and reduces the chance of heart attack or stroke	Irritation of the stomach lining (Aspirin) Bleeding in the stomach Easy bruising or bleeding Unexplained sore throat, fever, mouth ulcers (when Ticlopidine is taken)	Take after meals to reduce gastric irritation of the stomach lining (aspirin) Add pressure to wounds to stop bleeding Avoid rubbing bruises Inform your doctor or dentist that you are taking a blood thinner See a doctor immediately if there is unprovoked or unexplained bleeding Observe dietary advice and avoid taking supplements or traditional medicines/herbs without consulting your doctor or pharmacist (if taking warfarin)
	Dipyridamole
	Ticlopidine Clopidogrel Prasugrel Ticagrelor
	Dabigatran Rivaroxaban
	Warfarin
Cholesterol-lowering agents	Atorvastatin Lovastatin Pravastatin Rosuvastatin Simvastatin	Decreases the body's production of cholesterol	Unexplained and persistent muscle pain or stiffness Constipation / diarrhoea Flatulence Abdominal pain	Take after meals, preferably at night Inform your doctor or pharmacist if persistent muscle pain occurs
Fenofibrate Gemfibrozil	Reduces fat formation	Unexplained and persistent muscle pain or stiffness Rash Itchiness
Calcium-channel blockers	Amlodipine Nifedipine LA Felodipine	Relax blood vessels and lower high blood pressure	Headache Flushing Swelling of feet/lower legs Changes in heart rate	Change position SLOWLY from lying to sitting to standing to reduce dizziness Lifting up the legs may help to improve swelling