Heart Failure Medicines• ACE (angiotensin-converting

enzyme) inhibitors• ARBs (angiotensin receptor

blockers) • Beta-blockers• Spironolactone• Diuretics (water pills)• Potassium• Digoxin

ACE INHIBITORS

Examples of these are:

–Lisinopril

–Fosinopril

–Enalapril

–Captopril

ACE inhibitors

• Block the effects of harmful hormones on your heart muscle. This prevents the heart from getting larger

• Lower the blood pressure• Have benefits even if you do not

have high blood pressure• Helps to keep you out of the

hospital and you may live longer

Side effects of ACE Inhibitors

• Cough• Dizziness• Skin rash• High potassium levels in your blood

**** If you develop swelling of the face, tongue, or mouth, stop taking the medicine and call your doctor ****

Angiotensin Receptor Blockers

• Examples of these are:– Losartan (Cozaar®)

– Candesartan (Atacand®)

• Effects similar to ACE inhibitors– Keeps you out of the hospital– You may live a longer and

healthier life

Beta-Blockers• Examples of these are:

– Carvedilol (Coreg)

– Metoprolol (Lopressor, Toprol XL )

– Atenolol

– Propranolol

Beta-Blockers• Block the effects of harmful hormones

on your heart muscle. This prevents the heart from getting larger

• Lower your blood pressure• Slow the heart ratelessen the work

your heart has to do• Prevent heart attacks in patients who

have coronary artery disease

By regularly taking these types of medications:

The pumping action of the heart may improve over time

Helps to keep you out of the hospital

You may live a longer and healthier life

Side effects of Beta-Blockers• Initially you may feel tired or dizzy. This usually

gets better your body adjusts.

• It may take anywhere from 1 to 3 months to feel better. Stick with the regimen because the benefits are tremendous.

• If you have more shortness of breath or weight gain from fluid build-up, notify your provider

Target Dose

• Usually ACE-Inhibitors and Beta-blockers are started in low doses and increased gradually to the “target doses”

• If you cannot tolerate the higher doses your provider will get to a dose that is best for you.

What is meant by target dose?

The target dose is the dose which

has been shown in clinical

research to give the most benefit

For example….

• You may be started on Carvedilol 3.125 mg twice daily

• On your next appointment the dose may be increased to 6.25 mg twice daily

• Would continue doing this till you reach the target dose 25 mg twice daily

Spironolactone

• Given to some patients with advanced heart failure

• A low dose reduces symptoms of heart failure

• Helps to keep you out of the hospital

• May increase the potassium level

Diuretics (“Water Pills”)

• Examples of these are:– Furosemide (Lasix)

– Hydrochlorothiazide

– Metolazone

– Bumetanide

Diuretics (“Water Pills”)• Help your body get rid of excess water.

You will feel better and breathe better.• Try to take these medications in the

daytime no later than 4pm • Your blood will be checked periodically

to make sure your potassium level is normal.

Potassium Supplements

• When you take a water pill, your body may lose potassium.

• If your blood potassium level is low, then a supplement is prescribed.

Reminder…..

You may be taking different types of medicines which may increase or decrease your potassium level.

It is very important to go to your doctor’s appointments to have have your labs checked and medications adjusted.

Digoxin• Helps reduces symptoms of heart

failure

• Helps the heart to pump stronger

• Helps to keep you out of the hospital.

• Not given to all heart failure patients.

Digoxin

• Your provider may check your blood digoxin level

• Notify your provider if you experience any of the following:– Loss of appetite– Blurry vision– Stomach pain, nausea, vomiting– Confusion or extreme tiredness

Cholesterol Medicines

• Many of you may be taking:

– Simvastatin (Zocor®), Atorvastatin (Lipitor®), Lovastatin or Fluvastatin

• Some other types include:

Niacin (Niaspan®)

Gemfibrozil (Lopid®)

Tips to remember

• You should always take your morning medicines before your doctor’s appointment.

• If you miss a dose of a medication, it is important not to double up on the dose.

• Please do not to run out of your medicines

VA automated refill system

• Mail in slips

• Drop slips in box outside outpatient pharmacy

• Touch-tone phone