What are heart failure medications?
Heart failure medications are prescription drugs that help your heart work better. Heart failure, also called congestive heart failure, is a long-term condition. It affects nearly 6 million people in the U.S.
If you have heart failure, your heart can’t pump blood as well as it should. Over time, this leads to fluid buildup (congestion) in different parts of your body, including your legs, feet and lungs. You may also feel other symptoms including shortness of breath and fatigue.
Heart failure is progressive, meaning it gets worse over time. Treatment is essential to lower your risk of serious complications, like organ damage and sudden cardiac arrest. Treatment involves both lifestyle changes and medications. Some people need surgery.
Medications can’t cure heart failure. But they can slow down its progression and improve your quality of life. People with heart failure usually need to take several different medications. That’s because each drug does a different job within your body to manage heart failure and its symptoms.
Your healthcare provider will decide the best medications for you based on your symptoms, your other medical issues (like diabetes, high blood pressure and kidney disease) and how far your condition has progressed. Your provider may change your treatment plan as you go along. For example, they may adjust your dose or change medications. Many of these medicines lower your blood pressure, so your provider will work with you to find a combination that works for you and keeps your blood pressure normal.
Your provider may also prescribe other medications to manage other circulatory system problems.
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What is the first drug of choice for heart failure?
Healthcare providers often prescribe ACE inhibitors and beta blockers as first-line treatments. These drugs are especially helpful for people who have a reduced ejection fraction. This means your left ventricle (the main pumping chamber of your heart) isn’t pumping enough blood to your body.
But it’s important to know that there’s no single path for heart failure treatment. Providers tailor treatment to your individual needs. So talk with your provider about the main goals of your treatment plan and how medication can help you reach those goals.
What medications are commonly given to patients with heart failure?
We list commonly prescribed medications for heart failure below. They’re organized by medication class. A medication class is a group of drugs that are similar in some way. For example, all the drugs in one class might have the same active ingredient or treat the same problem.
Your healthcare provider will explain to you which drugs you need and why you need them. The regimen that’s right for you depends on what type of heart failure you have.
Angiotensin-converting enzyme inhibitors (ACE inhibitors)
ACE inhibitors help your heart pump better, open up (dilate) and relax your blood vessels so blood can flow better throughout your body, manage your blood pressure, lower your risk of a heart attack and help prevent stress hormones from making your heart failure worse. ACE inhibitors include:
- Captopril (Capoten®).
- Enalapril (Vasotec®).
- Fosinopril (Monopril®).
- Lisinopril (Prinivil®, Zestril®).
- Perindopril (Aceon®).
- Quinapril (Accupril®).
- Ramipril (Altace®).
- Trandolapril (Mavik®).
Angiotensin-2 receptor blockers (ARBs)
ARBs help your heart pump better, and open up (dilate) and relax your blood vessels so blood can flow better throughout your body. These include:
- Candesartan (Atacand®).
- Losartan (Cozaar®).
- Telmisartan (Micardis®).
- Valsartan (Diovan®).
ARB + neprilysin inhibitor (ARNIs)
ARNIs helps with severe heart failure and a low ejection fraction, and lowers blood pressure. An example of an ARNI is sacubitril-valsartan (Entresto®).
Beta blockers
Beta blockers lower the workload on your heart, help your heart pump better, help manage your blood pressure, lower your risk of a heart attack, help prevent stress hormones from making your heart failure worse and keep your heart rhythm normal. Beta blockers include:
- Bisoprolol (Zebeta®).
- Carvedilol (Coreg®, Coreg CR®).
- Metoprolol succinate (Toprol XL®).
- Nebivolol (Bystolic®).
Digoxin
Digoxin slows down your heart rate, helps people with atrial fibrillation and heart failure, and helps people who still have symptoms despite taking other medications. Digoxins are sold under a variety of brand names, including Cardoxin®, Digitek®, Digox® and Lanoxin®.
Diuretics (water pills)
Diuretics get rid of extra fluid in your body, help your heart pump better, make it easier for you to breathe, reduce swelling in your belly, feet and legs, and lower your blood pressure. Diuretics include:
- Bumetanide (Bumex®).
- Chlorothiazide (Diuril®).
- Hydrochlorothiazide, HCTZ (Esidrix®, HydroDIURIL®).
- Indapamide (Lozol®).
- Furosemide (Lasix®).
- Metolazone (Zaroxolyn®).
- Torsemide (Demadex®).
Hydralazine and isosorbide dinitrate
Isosorbide (Isordil®) and Hydralazine (Apresoline®, BiDil®) open up your blood vessels so blood can flow better throughout your body and lowers your blood pressure.
I(f) channel inhibitor
Ivabradine (Corlanor®) is an I(f) channel inhibitor that slows down your heart rate.
Mineralocorticoid receptor antagonists (MRAs)
Mineralocorticoid receptor antagonists, also called aldosterone antagonists, prevent stress hormones from making your heart failure worse and raise the potassium level in your blood.
- Eplerenone (Inspra®).
- Spironolactone (Aldactone®).
Sodium-glucose cotransporter 2 inhibitors (SGLT 2 inhibitors)
SGLT 2 inhibitors lower your risk of hospitalization for heart failure. Scientists are studying exactly how these drugs have this effect. These include:
- Dapagliflozin (Farxiga).
- Empagliflozin (Jardiance).
