Heart Failure: Avoiding Medicines That Make Symptoms Worse
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.
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
|
Over-the-counter medicines you may need to avoid (talk to your doctor or
pharmacist)
|
Prescription medicines you may need to avoid (talk to your doctor or
pharmacist)
|
|
Pain relievers called NSAIDs
- Ibuprofen, such as Advil and Motrin
- Naproxen, such as Aleve
- Aspirin, such as Bayer
- If your doctor has told you to take a
low-dose aspirin every day for your heart problems, it's probably okay to take
it. Low-dose aspirin can help prevent blood clots and may prevent a stroke or a
heart attack.
- Higher doses of aspirin may make your heart failure
worse. Do not take aspirin for pain, such as from headaches or arthritis. Use
acetaminophen, such as Tylenol, instead.
|
Pain relievers
- Celecoxib
-
Etodolac
- Indomethacin
- Ibuprofen
-
Ketoprofen
- Nabumetone
- Naproxen
- Piroxicam
- Sulindac
|
|
Cold, cough, flu, or sinus medicines
- Be sure to check the label. Do not take
medicines that contain pseudoephedrine, ephedrine, phenylephrine, or
oxymetazoline, such as:
- Sudafed.
- Nose sprays
(decongestants), such as Afrin and Dristan.
- Herbal remedies, such
as ma huang and Herbalife.
- Make sure your cough and cold medicines
don't contain aspirin or ibuprofen.
|
Antiarrhythmics
- These are drugs used to treat a fast or
uneven heart rhythm. You may need to avoid the following:
- Disopyramide
- Dofetilide
- Flecainide
- Procainamide
- Propafenone
- Quinidine
- Sotalol
|
|
Antacids or laxatives that contain sodium
- Check the label for sodium or saline. Examples include:
- Antacids, such as Alka-Seltzer.
- Laxatives, such as Fleet Phospho-Soda.
|
Calcium channel blockers
- People with a certain kind of heart
failure may need to avoid the following medicines:
- If you need to take a calcium channel
blocker for another health problem, such as high blood pressure, your doctor
will watch your health carefully.
|
| |
Certain diabetes medicines
- Most diabetes drugs are safe to take, but
you may need to avoid the following:
|
| |
Certain antibiotics
- Some antibiotics may interfere with how
your body uses the medicine digoxin. If you take digoxin, talk with your doctor
before taking antibiotics.
|
Test Your Knowledge
-
You have headaches a lot. Instead of taking aspirin or
ibuprofen, you need to take acetaminophen.
-
True
This answer 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.
-
False
This answer 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.
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.
Test Your Knowledge
-
Your doctor told you that you need to limit how much
sodium (salt) you have each day. This includes any sodium in your
medicines.
-
True
This answer is correct.
Your doctor may have told you to limit your
sodium intake to less than 2,000 milligrams (mg) a day. If you take a medicine
that contains sodium, that counts as part of your total sodium intake each day.
-
False
This answer is incorrect.
Your doctor may have told you to limit your
sodium intake to less than 2,000 milligrams (mg) a day. If you take a medicine
that contains sodium, that counts as part of your total sodium intake each day.
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.
Test Your Knowledge
-
You've suddenly gained a few pounds. This may be a
sign that your heart failure is getting worse, so you need to call your
doctor.
-
True
This answer is correct.
If you gain weight suddenly, such as
3 lb (1.4 kg) or more in 2 to 3
days, call your doctor. Call if you have new shortness of breath, a cough, or
problems eating. Call if your ankles are more swollen than usual, if you have
to urinate in the night more often, or if you need to use more pillows to sleep
at night.
-
False
This answer is incorrect.
If you gain weight suddenly, such as
3 lb (1.4 kg) or more in 2 to 3
days, call your doctor. Call if you have new shortness of breath, a cough, or
problems eating. Call if your ankles are more swollen than usual, if you have
to urinate in the night more often, or if you need to use more pillows to sleep
at night.
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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