Heart failure is a serious condition that affected over 6 million adults in the United States between 2013 and 2016.

Heart failure is when your heart is unable to pump blood and oxygen to your body in an efficient way. The condition may be acute (sudden) or chronic (long lasting) and can affect one or both sides of your heart.

The good news is that today’s medications are helping improve the outlook for those living with heart failure.

There are many medications available to treat different types of heart failure. These medications can improve blood flow, lower your heart rate, or improve other underlying risk factors for heart failure.

You may need more than one type of medication for your condition. The medication(s) your doctor prescribes will depend on your general health, other conditions you may have, other medications you may be taking, and other individual factors.

In this article, we’ll discuss the different types of heart failure medications, their effectiveness and side effects, and other important information.

ACE inhibitors are a class of medications that block angiotensin (a hormone) and fluid buildup. If you have heart failure, too much angiotensin can raise your blood pressure, straining your heart.

ACE inhibitors help lower blood pressure by allowing blood vessels to relax, increasing blood flow to your heart.

Some examples of ACE Inhibitors include:

These are just a few examples. A doctor can provide more complete information on these types of medications, their uses, and any risks.

ACE inhibitors are commonly used to treat congestive heart failure. This is when blood and fluids build up, making it difficult for your heart muscle to pump effectively.

ACE inhibitors are considered one of the first options to treat heart failure with reduced ejection fraction. Their use may help prevent hospitalizations and worsening heart failure symptoms.

Possible risks and side effects

Some possible side effects of ACE inhibitors include:

These are not all the possible side effects of ACE inhibitors. Ask your pharmacist for more information and what to expect. Your doctor will monitor your kidney function and your potassium levels while you’re on these medications.

ACE inhibitors have an FDA black box warning. This is the most serious warning about a medication. You shouldn’t take these medications if you’re pregnant or plan to become pregnant. Ask your doctor for more information about this risk.

If you feel you’re experiencing a life threatening reaction to an ACE inhibitor or any medication, call 911 or have someone take you to your nearest emergency medical center immediately.

ARBs are another class of medications used to treat heart failure. They work by blocking receptors for the hormone angiotensin II. This helps relax your blood vessels, reduces water retention, and improves your heart’s ability to pump blood.

A doctor will sometimes prescribe this class of medications if you’re unable to tolerate ACE inhibitors.

ARBs are also available combined with another type called hydrochlorothiazide. This is a diuretic (water pill) that helps lower your blood pressure and reduces fluid buildup.

Some examples of ARBs include:

Possible risks and side effects

Possible side effects of ARBs include:

These are not all the possible side effects of ARBs. These medications can also interact with other medications you’re taking.

Serious allergic reactions, liver or kidney failure, angioedema (tissue swelling), and other serious side effects are also possible with ARBs. In case of a severe reaction, call 911 or go to your nearest emergency medical center right away.

ARBs have a black box warning. This is the strongest type of FDA warning about the risks of a drug. It’s not recommended for use during pregnancy.

Talk with your doctor or pharmacist for more complete information about the side effects, risks, and precautions that you should know before taking ARBs.

This class of medications works by blocking the effects of the hormone aldosterone in your body.

Aldosterone receptor antagonists help water and sodium to leave your body. This helps lower your blood pressure, reduce fluid buildup, and improve your heart’s ability to pump blood.

They are often recommended for the treatment of chronic heart failure with reduced left ventricular ejection fraction and are effective in reducing hospitalizations and death.

Examples of these medications include:

Clinical trials have shown that aldosterone antagonists are effective for treating heart failure either alone or in combination with other medications.

Possible risks and side effects

Possible side effects of these medications include:

  • cough
  • diarrhea
  • dizziness
  • fatigue
  • leg cramps
  • headache
  • gynecomastia, or enlarged male breasts
  • high potassium levels, which may be serious — your doctor will monitor your potassium levels while taking these medications

These are not all the possible side effects of aldosterone antagonists. They can also interact with other medications you take. Talk with your doctor or pharmacist for more information.

Aldosterone antagonists can cause allergic reactions and kidney problems. Your doctor will evaluate your kidneys before and during treatment with these medications.

If you experience a serious side effect, such as hives, facial swelling, or trouble breathing, call 911 or go to an emergency medical center.

This is a new type of medication for treating heart failure. It’s available as a combination of two different medications, an ARB and a neprilysin inhibitor.

ARNIs are approved to treat chronic heart failure with ejection fraction problems. The medication helps to relax blood vessels and lower fluid buildup, reducing pressure on your heart.

Clinical trials have shown that the combination medication was effective at lowering hospitalizations and death in people with chronic heart failure compared to using an ACE inhibitor (enalapril) alone.

One example of this type of medication is the combination of sacubitril and valsartan (Entresto).

A 2019 study found that sacubitril-valsartan lowered the risk of hospitalization and death compared to ACE inhibitor/ARB medications in those with systolic heart failure.

Possible risks and side effects

Possible side effects of ARNIs include:

  • dizziness
  • cough
  • low blood pressure
  • angioedema
  • high potassium levels
  • kidney problems

This drug has a black box warning from the FDA. You should not take Entresto if you’re pregnant or planning to become pregnant.

Your doctor can provide more information about all the side effects, drug interactions, and risks of this type of medication.

Beta-blockers are used to treat different kinds of heart conditions. They work by blocking the effects of certain hormones like the stress hormone adrenaline. This helps lower blood pressure, slow our heart rate, and reduce pressure on the heart and your body’s demand for oxygen.

These medications improve heart function and symptoms of heart failure.

Examples of beta-blockers include:

Beta-blockers are recommended by the American Heart Association and European Society of Cardiology guidelines for people with systolic heart failure with reduced ejection fraction.

Possible risks and side effects

Some possible side effects of beta-blockers include:

In rare cases, you may experience trouble breathing, confusion, or irregular heart rate. If you feel you’re experiencing a serious medical emergency, such as any of these symptoms, call 911 right away or go to your nearest emergency medical center.

Beta-blockers have a black box warning from the FDA. Don’t suddenly stop taking a beta-blocker medication. This could worsen chest pain, cause a sudden increase in blood pressure, and even increase your risk of a heart attack.

If you need to stop taking a beta-blocker, your doctor will gradually ease you off the medication while monitoring you.

These are not all the side effects of beta-blockers. Your doctor or pharmacist can tell you more about side effects, interactions, and other important information about these medications.

Diuretics (water pills) are used in treating heart failure to reduce fluid buildup in your blood vessels and body. They also lower blood pressure, which helps reduce stress on your heart.

There are a few types of diuretics, including:

Thiazide diuretics

Loop diuretics

Potassium sparing diuretics

Possible risks and side effects

Some possible side effects of diuretics include:

These are not all the side effects of diuretics. Your doctor or pharmacist can tell you more about specific medications you’re prescribed and any interactions or other precautions.

Diuretics can cause serious side effects such as an allergic reaction, kidney problems, or irregular heart rate. Your doctor will monitor your kidneys and potassium levels regularly while you’re taking these medications.

For any serious side effects, call your doctor. If you think you’re experiencing a life threatening emergency, call 911 immediately or go to an emergency medical center.

Your doctor may prescribe other medications for heart failure based on your symptoms, as well as other individual factors.

Some examples of these other types of medications include:

  • Digoxin (Lanoxin): slows heart rate and improves how your heart fills with blood to manage heart failure symptoms
  • Vasodilators (hydralazine): widens blood vessels and helps lower blood pressure
  • I(f) channel blockers (ivabradine): helps lower heart rate and reduces hospitalizations and worsening of heart failure symptoms
  • Statins: helps lower high cholesterol
  • Blood thinners (anticoagulants): for those with risk of blood clots
  • Nitrates: helps with chest pain

In addition, if you have diabetes or other heart-related conditions, your doctor may prescribe medications for these conditions, which may improve heart function and your overall health.

There are different types of heart failure. Your treatment plan will depend on the type of heart failure you have, any coexisting conditions, your age, your overall health, and other factors.

A doctor can provide specific information on which medication(s) and dosage would work best for you.

It’s important to take your medication(s) exactly as prescribed by your doctor to improve your symptoms and prevent worsening of heart failure.

If you’re experiencing side effects from your medication, talk with your doctor or pharmacist. They can offer suggestions to reduce these side effects or discuss other treatment options if needed.

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