Introduction to Medications

Many medications have been shown to make people with heart failure live longer and feel better. These medications work in different ways. They may help by strengthening the heart’s pumping function or by reducing the amount of work that the heart has to do.

Doses of Medication

Most medications in heart failure are started off at a low dose, and the dose is increased over several weeks to a “target” dose. When you are first diagnosed with heart failure, your health care provider may see you in clinic quite frequently in order to adjust your medications and get you on the optimal doses of each medication. It is normal for your dose to change frequently in the first few months. It may take several days or a week for your body to adjust to the new dose of medication. If you experience worrisome side effects (extreme fatigue, frequent dizzy spells, or fainting episodes) you should call your health care provider.

It’s important that you learn the name, dose, frequency and the purpose of all your medications. Not all patients with heart failure are on the exact same medications and your health care provider can discuss with you why he/she has chosen a certain combination of medications for you.

Medications for heart failure belong to several different classes (or families). Each group affects the heart in a different way, and you may need one from each group. It is important to understand how they work, and what the potential side effects are. These medication classes include:

• beta-blockers
• angiotensin converting enzyme inhibitors (ACEIs) & angiotensin receptor blockers (ARBs)
• neprilysin inhibitor/angiotensin II receptor blocker (Entresto^TM)
• diuretics (water pills)
• aldosterone antagonists
• vasodilators & nitrates
• digoxin
• potassium supplements

You may not be on all the types of medications listed above. If you are not on one of these medications and are wondering why, speak to your health care provider.

General Advice on Your Medications

• Take your medications exactly as directed. Do not stop or start any medications without speaking to your health care provider.
• There may be some medications that your health care provider will tell you not to take if you are feeling sick and are dehydrated. Talk to your health care provider about your “Sick Day” list of medications.
• Learn the name, dose and frequency of your medications and take them at the same time every day.
• If you have difficulty remembering to take all your pills, ask the pharmacist to create a “blister pack” for you.
• If you miss a dose of a medication, take it as soon as you remember. Take the next dose at the regular time. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
• Store your medications in a cool, dry place, away from direct heat, light or moisture.
• Keep medications out of reach of children.
• Do not use non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen (Advil^®, Motrin^®) or naproxen. These medications may make your heart failure worse. Ask your health care provider or pharmacist before taking over the counter medications or herbal remedies.
• Medications may have side effects. Sometimes these side effects go away with time, or become less bothersome. If you are concerned about a side effect, speak to your health care provider. Do not stop a medication without checking with your health care provider first.

If paying for your medications is an issue, talk to your health care provider about the Ontario Trillium Drug Program . Their phone number is 1-800-575-5386.