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All Your Questions about Heart Failure Medications Answered

Updated: Oct 25, 2021

If you have heart failure, the idea of taking so many medications might be overwhelming to you.

  • Why do I have to take so many?

  • Aren’t they all the same?

  • Can’t I just take one pill and call it a day?

The reality is that heart failure is a complex condition, and it varies based on your health status and your class—or stage—of heart failure. In order to manage all aspects of the condition, your doctor might prescribe multiple medications.

Unfortunately, they don’t always get to explain each of those medications to you, why you’re taking them, how they work, or what potential side effects you could have. This article will explain each of those to you.

Which medications treat congestive heart failure?

When it comes to heart failure meds, they have 3 main goals:

  1. Slow the wearing down of your heart

  2. Reduce your risk of having serious problems associated with heart failure, including severe symptoms, poor quality of life, and hospitalization

  3. Reduce your risk of dying from heart failure​

The medications commonly prescribed for heart failure are designed to keep your heart healthier longer by preventing it from having to work as hard. Most do this by relaxing your blood vessels and/or lowering your blood pressure. At minimum, you’ll probably be taking at least 3 types of medications to tackle your heart failure.

Let’s go over all the classes of heart failure medications, their names, how they work, and what side effects they could cause.

Drug class: angiotensin-converting enzyme (ACE) inhibitors

Drugs: lisinopril, captopril, enalapril, fosinopril, moexipril, perindopril, quinapril, benazepril, trandolapril, ramipril

How they work: relax blood vessels and decrease blood pressure

Possible side effects: raise potassium levels, kidney changes, dry cough, lip/facial swelling*

*Lip, mouth, or facial swelling is a sign of an emergency called angioedema. If you’re taking an ACE inhibitor and notice this type of swelling, get to an emergency room right away. Let the healthcare providers know you take an ACE inhibitor, and never take an ACE inhibitor again.

Drug class: angiotensin II receptor blocker (ARBs)

Drugs: losartan, valsartan, olmesartan, candesartan, irbesartan, telmisartan, eprosartan

How they work: relax blood vessels and decrease blood pressure

Possible side effects: same as ACE inhibitors, but the risk of a dry, persistent cough is much lower with ARBs

Drug class: beta-blockers

Drugs: carvedilol, metoprolol succinate, bisoprolol

How they work: decrease blood pressure, lower heart rate

Possible side effects: dizziness, fatigue, initial worsening of heart symptoms

Drug class: diuretics, also known as water pills

Drugs: furosemide, bumetanide, torsemide, metolazone

How they work: get rid of extra fluid in the body via urination

Possible side effects: increased urination, dehydration, kidney changes, skin rash, increased blood sugar

Drug class: aldosterone antagonist

Drugs: spironolactone, eplerenone

How they work: decrease aldosterone, a hormone that can cause damage to the heart

Possible side effects: kidney changes, breast tenderness or swelling, raise potassium

Drug class: nitrate/hydralazine

Drugs: isosorbide dinitrate/hydralazine

How they work: relaxes blood vessels

Possible side effects: dizziness, headache, limb swelling

Drug class: cardiac glycosides

Drugs: digoxin

How they work: slows heart rate and helps it pump better

Possible side effects: dizziness, mood changes; nausea, vomiting, changes in vision*

*Nausea, vomiting, and changes in your vision are signs of digoxin toxicity which can be life-threatening. If you have any of these symptoms, get medical help immediately.

All these drugs, except the diuretics class and digoxin, go the extra mile by lowering your risk of dying from heart failure.

Are there new heart failure medications?

The two newest heart failure medications, Entresto (sacubitril/valsartan) and Corlanor (ivabradine), both hit pharmacy shelves in 2015 and also improve your chances of survival.

Entresto is a combination pill, so when you take it, you’re actually taking two ingredients: sacubitril and valsartan. The drug belongs to a class called angiotensin receptor-neprilysin inhibitors (ARNIs).