Heart Failure: Avoiding Medicines That Make Symptoms Worse

Introduction

If you have heart failure, you need to be extra careful with medicines. Some can make your heart failure worse. Other medicines may not mix well with your heart failure drugs.

This Actionset will help you learn which medicines you may need to avoid and what questions to ask your doctor or pharmacist.

• Each time you see a doctor, make sure he or she knows that you take medicines for heart failure.
• Before you fill any new prescription, tell the pharmacist that you have heart failure. Ask if it's okay to take the new prescription medicine.
• Before you take any over-the-counter medicine, such as a cold or flu remedy, ask your doctor or a pharmacist if it is safe to take it with your heart failure medicines.
• Tell each doctor about all the other medicines you take. This includes over-the-counter medicines, such as cold and flu remedies, herbal products, and natural supplements and vitamins. Take a list of your medicines or bring your medicines to each doctor's appointment.
• Whether or not some medicines will make your heart failure worse depends on how severe your heart failure is. It also depends on what type of heart failure you have.

 What medicines can make heart failure worse?
 Why may you need to avoid certain medicines?
 How do you know if your other medicines are safe to take with your heart failure medicines?
 Where to go from here

What medicines can make heart failure worse?

There are many medicines that you'll need to avoid when you have heart failure. Some are over-the-counter drugs that you can buy without a prescription. Others are drugs that a doctor may prescribe.

Do not start taking any of the medicines listed in the table below unless your doctor says it is okay and he or she knows that you have heart failure. If your heart failure is mild, you may be able to use some of the medicines for a short time, but it's very important to ask your doctor first.

If you are already taking a medicine on the list below, be sure to ask your doctor or pharmacist if it is okay to take it.

Medicines you may need to avoid

Test Your Knowledge

1. You have headaches a lot. Instead of taking aspirin or ibuprofen, you need to take acetaminophen.

1. True

You have headaches a lot. Instead of taking aspirin or ibuprofen, you need to take acetaminophen.

You chose true, which is correct.

Aspirin and ibuprofen are types of over-the-counter medicines that can make your heart failure worse. But if your heart doctor has told you to take a low-dose aspirin for your heart, this is probably okay. Make sure to talk with your doctor about this.

2. False

You have headaches a lot. Instead of taking aspirin or ibuprofen, you need to take acetaminophen.

You chose false, which is incorrect.

Aspirin and ibuprofen are types of over-the-counter medicines that can make your heart failure worse. But if your heart doctor has told you to take a low-dose aspirin for your heart, this is probably okay. Make sure to talk with your doctor about this.

Continue to Why may you need to avoid certain medicines?
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Why may you need to avoid certain medicines?

Some drugs or herbal remedies could interfere with your heart failure medicines. This is called a drug interaction. It happens when different medicines work against each other and cause problems.

Other drugs may make your heart failure worse by speeding up your heart or making it beat in a way that's not normal. Other medicines can cause your body to hold onto fluid or increase your blood pressure.

Some drugs have too much sodium in them. Sodium causes your body to hold on to extra water, making it harder for your heart to pump. Too much sodium makes it harder for your already-weakened heart to pump and can lead to sudden heart failure. Fluid may build up in your lungs—which makes it harder for you to breathe—and in your feet, ankles, legs, and belly.

Your doctor may have told you to limit your sodium intake to less than 2,000 milligrams (mg) a day. That is less than 1 teaspoon of salt a day, including all the salt you eat in cooked or packaged foods.

If you take a medicine that contains sodium, it counts as part of your total sodium intake each day. It could cause you to go over your 2,000 mg limit. Look for sodium in the list of ingredients on each medicine you take.

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How do you know if your other medicines are safe to take with your heart failure medicines?

Talk to your doctor or a pharmacist. Show him or her a list of all the medicines you take.

Be organized

It's important to keep an up-to-date list of your medicines. Here are some tips:

• Make a list of everything you take. Keep a copy in your purse or wallet, and take it to each doctor or hospital visit. Anytime you see a new doctor, show him or her your list.
• Remember to include herbs, vitamins, and over-the-counter medicines on your list.
• Have each doctor keep a copy of your list of medicines in your file.
• Make sure your spouse, a family member, your caregiver, or a friend has an extra copy of your list of medicines.
• Use the same pharmacy or drugstore for all of your prescriptions.
• Update your list if you start a new medicine or stop taking one.

Ask questions

What if you need to take a medicine that can make heart failure worse? Here are some things you can do:

• Ask your doctor or a pharmacist if it is safe to take the medicine.
  • For example, if you have a cold or the flu, ask which medicine is safe to take.
  • Ask how long you should take the medicine and how much you should take. It may be safe to take it for a short time.

Watch for problems

Call your doctor if you have symptoms that your heart failure is getting worse, including the following:

• You gain weight suddenly, such as 3 lb (1.4 kg) or more in 2 to 3 days.
• You have new shortness of breath, a cough, or problems eating.
• Your ankles are more swollen than usual, and you have to get up more often in the night to urinate.
• You need to use more pillows to sleep at night.

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Where to go from here

Now that you have read this information, you can avoid medicines that may make your heart failure worse.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to mark areas or make notes in the margins where you have questions.

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References

Citations

1. Kaul S, et al. (2010). Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.

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