What do I need to know about medicines for heart failure?
Every person with heart failure has individual health needs, which your doctor will keep in mind when prescribing medicine to treat your heart failure.
If you have HFrEF you generally need to take medicines from three groups:
Angiotensin converting enzyme inhibitors (ACE inhibitors) (you can recognise these because the active ingredient ends in ‘pril’) Or Angiotensin receptor blockers (ARBs) (these are sometimes called angiotensin-2 receptor antagonists or ‘sartans’ because the name of the active ingredient ends in ‘sartan’)
These medicines block the effects of a hormone called angiotensin-II. When this hormone is inhibited or blocked by medicines, the blood vessels relax, reducing strain on your heart and making it easier for your heart to pump blood around your body.
If neither of these medicines improve your heart failure symptoms, you will be prescribed an angiotensin receptor-neprilysin inhibitor (ARNI).
Beta blockers (you can recognise these because the active ingredient ends in ‘olol’)
These work by blocking your body from releasing the stress hormones adrenaline and noradrenaline. This slows your heart down allowing it to pump more efficiently
Mineralocorticoid receptor antagonists (MRAs) These are sometimes known as aldosterone blockers. They work by blocking the effects of the hormone aldosterone. They can reduce some of the changes to your heart muscle that occur as a result of damage and help to control blood pressure.
Other heart failure medicines
People with heart failure may also be prescribed diuretics. These are sometimes referred to as ‘fluid tablets’, ‘water tablets’ or ‘water pills’.
They help remove extra fluid that builds up in your body when your heart is not pumping properly, by increasing the amount you urinate. Diuretics should help you feel better by reducing the swelling caused by fluid build-up and making it easier for you to breath.
If you have HFpEF, you will need to take diuretics alongside the medicine you need to manage other conditions.
Other heart failure medicines are prescribed less frequently. They include:
Ivabradine
which may be prescribed for you, in addition to other medicines, if your heart rate is too fast.
Digoxin which is prescribed to a small group of people who have heart failure as well as irregular heart rate (arrhythmia).
If you have any questions about your medicine, ask your prescribing doctor or pharmacist. The ‘5 Questions’ on the Choosing Wisely website has useful examples of the type of questions you might want to ask.
Some of these medicines have more than one name. It’s important to learn about the different types of medicines that have been prescribed for you, including their abbreviations and active ingredients.
If you want to find out more about the medicine that you have been prescribed, search for the active ingredient in Medicine Finder.
What side effects do I need to know about?
Most medicines have side effects, including those prescribed for heart failure. Possible side effects include tiredness, loss of appetite and dizziness.
Some of these symptoms can also be signs that your heart failure is worsening. If you are experiencing these symptoms, it’s important to discuss them with your doctor, especially after starting a new medicine.
Your medicine’s usual side effects are written on the patient information leaflet that comes with the medicine. You can find the leaflet for your medicine by searching its active ingredient or name in the Medicine Finder.
Most people only experience mild side effects. Many of these side effects will go away after a few days.
When you are prescribed a new medicine, your doctor should tell you about possible side effects. You can ask for more information about these, and find out which ones are more common. Write down any side effects that could be dangerous or need medical attention.
If the medicine you are taking makes you feel unwell, discuss this with your prescribing doctor.
You can also discuss some of your concerns with your community pharmacist or call our Medicines Line on 1300 MEDICINE (1300 633 424).
It’s a good idea to have a medicines list with written (or typed) information about all the medicines you need to take for heart failure and for any other conditions.
Your medicines list should be stored in a place that is easy to access for you and for anyone who cares for you. For each medicine you take, your list should include:
the amount of medicine you need to take and how often and when you need to take it.
the condition that you are taking the medicine for.
Keep this list with you at all times, especially during appointments with your health professionals in case they need to review it. Keep it up to date with all the medicines you are currently taking and their doses, and include any over-the-counter medicines, herbal or complementary preparations, or supplements you take without a prescription, as well as medicines that have been prescribed for you by your GP, cardiologist, or other specialist.
Not without speaking to your doctor. Feeling OK usually means the medicines are working properly.
Most people with heart failure need to take more than one medicine every day. It’s important to take these medicines as prescribed, even if you feel well, because that is the best way to help your heart work properly.
If you are worried about the medicines that have been prescribed for you, speak to your prescribing doctor or pharmacist.
Do not stop taking your medicine or change the dose that has been prescribed, unless your GP or cardiologist agrees it is a good idea.
Will the medicines that I take for heart failure now always stay the same?
The medicines you take for heart failure are likely to change over time.
The changes will depend on your healthcare needs, your symptoms and the type of heart failure you have.
If you have been diagnosed with HFrEF, your medicine will start at a lower dose and will gradually be increased. It may take multiple changes over weeks or months to achieve your target dose of each medicine.
Your medicines will be reviewed regularly to make sure that they are helping you.
How do I know if my medicine is not working?
You should always take your heart failure medicine in the way that it has been prescribed.
If you are following the instructions on your medicines list but are finding it hard to breathe, move or complete your usual daily activities, or if you are having other symptoms of worsening heart failure, then it’s a good idea to ask your doctor to review your medicines.
You may need to have blood tests or other diagnostic tests, such as an echocardiogram or ECHO, to check how well your heart is working, or if your medicines need to change.
If you are having any signs of a heart attack, call triple zero (000) and ask for an ambulance. Common symptoms include: pain, pressure, heaviness or tightness in the chest, arm, back, jaw, neck or shoulder, dizziness, or difficulty breathing.
It’s important to be aware of the medicines that can make your heart failure worse. You can purchase some of these medicines in pharmacies without a prescription (over the counter), and some are available in supermarkets.
They include:
anti-inflammatory medicines for pain such as ibuprofen (example brand name, Nurofen®)
cough or cold and flu medicines containing pseudoephedrine or phenylephrine
some herbal or vitamin products or supplements
weight loss products or supplements
It’s important to talk to your prescribing doctor or pharmacist before taking any new medicines, vitamins or supplements.
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