Most people with heart failure will need to take several different medicines every day. These heart failure medicinesmay help you feel better right now. Over time they will helpyour heart to improve. Your health care provider will choose thebest medicines for you. It is very important that you take yourmedicines as prescribed even after you start feeling better.

• Do not run out of medicines. Keep your prescriptions filled.• Do not skip doses. • Do not stop medicines without talking with your doctor.• Talk to your doctor before you take any other medicines and

herbal remedies. That includes those you can buy without a prescription.

Medicines for Heart Failure

This is for education only. Ask your own doctor any questions you have about your health. © 2008 by Vanderbilt University. All rights reserved. Vanderbilt Medical Center Patient & Family Centered Care HC-0062 06/09

ACE InhibitorsCOMMON ANGIOTENSIN CONVERTING ENZYME INHIBITO R

Brand name and (Generic Name)

Capoten® (captopril), Vasotec® (enalapril),Prinivil®/Zestril® (lisinopril), Accupril® (quinapril),Altace® (ramipril), and Monopril® (fosinopril)

ACE inhibitors are usually the first drugs usedto treat heart failure. They relax the blood vessels. This reduces the workload on theheart. They also block the harmful effects ofthe hormone-like substances that make heart failure worse. Hormones are chemicalsreleased in your body that affect other parts ofthe body. ACE inhibitors help keep your heartfrom getting worse. They may help you feelbetter, live longer, and go to the hospital lessoften.

ACE inhibitors lower blood pressure. Yourdoctor may prescribe them because of otherbenefits even if you do not have high bloodpressure.

Dizziness is a common side effect.• Try taking your ACE inhibitor at another

time of the day if it makes you dizzy.• If you feel dizzy when you wake up in the

morning or when you get up after sitting for a long time,

--move your feet around and up and downbefore you stand up.

--stand up slowly and stand in one place fora few seconds before you start walking.

When your doctor orders lab tests, be sure toget them done.

DO NOT take ACE inhibitors if you are pregnant or think you may be pregnant.

Call your doctor if you have • Dizziness for more than 5-10 minutes after

you get up• Fainting spells• Coughing that will not go away• Skin rash

page 1 of 3 pages

Get medical help immediately if • Your lips or throat swell. It is a rare but

serious side effect.

Angiotensin Receptor BlockersCOMMON ANGIOTENSIN RECEPTOR BLOCKERS

Brand name and (Generic Name)

Atacand® (candesartan), Avapro® (irbesartan),Cozaar® (losartan), Diovan® (valsartan)

Angiotensin receptor blockers are similar toACE inhibitors. They relax the blood vessels. This reduces the workload on theheart. They also block the harmful effects ofthe hormone-like substances that make heartfailure worse. Hormones are chemicalsreleased in your body that affect other parts ofthe body. Angiotensin receptor blockers helpto keep your heart from getting worse. Theymay help you feel better, live longer, and go to the hospital less often.

Angiotensin receptor blockers lower bloodpressure. Your doctor may prescribe thembecause of other benefits even if you do nothave high blood pressure.

Side effects Dizziness is a common side effect. Let yourdoctor know if you feel dizzy.• It may help to take this medicine at different

times of the day.• If you feel dizzy when you wake up in themorning or when you get up after sitting for along time, you may want to try--moving your feet around and up and down

before you stand up.--standing up slowly and standing in one place

for a few seconds before you start walking.

When your doctor orders lab work, be sure tohave it drawn.

DO NOT take angiotensin receptor blockers ifyou are pregnant or think you are pregnant.

Call your doctor if you have• Dizziness for more than 5-10 minutes after

you get up• Trouble walking with the dizziness• Fainting spells• Coughing that will not go away• Skin rash

Beta-blockersCOMMON BETA-BLOCKERS

Brand name and (Generic Name)

Zebeta® (bisoprolol), Coreg® (carvedilol), and Toprol® (metoprolol succinate)

Beta-blockers help lower blood pressure andslow your heart rate. They also block the harmful effects of some of the hormone-likesubstances that make heart failure worse.Hormones are chemicals released in your bodythat affect other parts of the body. Beta-block-ers may improve the pumping action of yourheart over time.

Beta-blockers lower blood pressure. Your doctor may prescribe them because of otherbenefits even if you do not have high bloodpressure. They may help you feel better, livelonger, and go to the hospital less often.

Side effects These side effects are common in the first twoweeks after starting the medicines but usuallydisappear over time. • feeling tired• dizziness• slower heartbeat

page 2 of 3 pagesPatient & Family Centered Care HC-0062 06/09

Call your doctor if you have any ofthese side effects• Fluid buildup. Keep a daily record of your

weight. • Wheeze or have more shortness of breath• Low blood pressure. Know your normal

blood pressure.• Low pulse. Know your normal pulse rate.

DiureticsCOMMON DIURETICS

Brand name and (Generic Name)

Lasix® (furosemide), Bumex® (bumetanide),Demadex® (torsemide), and HCTZ®(hydrochlorothiazide)

Diuretics, or "water pills," help rid your bodyof extra fluid that may collect in your lungs,stomach, or feet and ankles. When you haveless fluid, your heart does not have to work sohard. Diuretics may also rid your body ofpotassium. You may need a prescription forpotassium supplements if your potassium levelbecomes too low.

When your doctor orders lab tests, be sure toget them done.

Side effectsSide effects include dizziness, weakness, gout,and muscle cramps. These are usually causedby low potassium.

Call your doctor if you have any ofthese side effects• Muscle cramps• Dizziness• Fast heartbeat

Aldosterone AngonistCOMMON ALDOSTERONE AGONISTS

Brand name and (Generic Name)

Aldactone® (spironolactone) and Inspra® (eplerenone)

Aldosterone antagonist decreases the harmfuleffects of aldosterone. Aldosterone controlsthe balance of salt and water in the body.

Side effect• High potassium level in your blood

When your doctor orders lab tests, be sure tohave them done.

Hydralazine and IsosorbideCOMMON VASODILATOR AND NITRATE

Brand name and (Generic Name)

Imdur® (isosorbide mononitrate), Isordil® (isosor-bide dinitrate) and Apresoline® (hydralazine)

The combination of hydralazine and isosor-bide relaxes the blood vessels and makes themwider.

Call your doctor if you have any ofthese side effects• Dizziness• Headache• Nausea• Vomiting

Digoxin Digoxin® (Lanoxin) can help your heart muscle pump blood better. It can also regulatea heartbeat that is too rapid or irregular. Notall heart failure patients need to take digoxin.

When your doctor tells you to get lab tests, besure to get them done.

Call your doctor if you have • Blurred, bluish or yellowish vision• No appetite• Nausea or vomiting • Pulse that is too slow or too fast

page 3 of 3 pagesPatient & Family Centered Care HC-0062 06/09