If used properly, prescribed medications can improve your loved one’s health, but you should also be aware of the medications’ potential side effects.
Aspirin can prevent blood clot formations that block the coronary arteries, which cause heart attacks. Research in patients with unstable angina has proven that taking an aspirin every day reduces the risk of heart attack. Acetaminophen (Tylenol) and ibuprofen (Advil) are not the same as aspirin, and should not be used in place of aspirin.
If your loved one has unstable angina, he or she will probably be told to take aspirin every day. Your loved one’s doctor will tell him or her how much to take.
ACE inhibitors—including captopril, enalapril, lisinopril, and quinapril—help to keep blood vessels from narrowing. As a result, your loved one’s blood pressure should drop and his or her heart should not have to work as hard to pump blood. ACE inhibitors have been shown to help heart failure patients live longer and feel better, but it may take a few weeks before your loved one feels better from taking the medicine.
Possible side effects of ACE inhibitors include:
- Skin rash
- Fluid retention
- Excess potassium in the bloodstream
- Kidney problems
- Altered or lost sense of taste
Beta-blockers can decrease both the amount of work your loved one’s heart needs to do and the amount of oxygen his or her heart needs.
Possible side effects of beta-blockers include:
- Skin rash
- Mental confusion
- Shortness of breath
Calcium-channel blockers relax blood vessels, and treat high blood pressure and chest pain.
Possible side effects of calcium-channel blockers include:
- Bradycardia (slow heartbeat)
- Asthenia (weakness)
Blood Cholesterol–Lowering Agents
HMG CoA reductase inhibitors (or “statins”), nicotinic acid, bile acid sequestrants, fibric acid derivatives, and probucol are among the agents used to lower blood cholesterol.
Possible side effects of blood cholesterol–lowering agents include:
- Abdominal pain
- Asthenia (weakness)
- Upper respiratory infection.
Diuretics, or “water pills,” will make your loved one urinate more often, thereby helping remove excess fluid and salt from his or her body. If your loved one experiences swelling in the feet, ankles, legs, and abdomen and shortness of breath when lying down or during physical activity, check with a physician about the effects of diuretics. The symptoms may also occur if doses are skipped.
The most commonly used diuretics are hydrochlorothiazide and furosemide (Lasix). Regular use of some diuretics can lead to the loss of potassium and to other nutritional imbalances. Blood tests are needed to monitor these levels. To replace lost potassium, your loved one may have to:
- Eat more foods rich in potassium (such as bananas and raisins)
- Drink orange juice and other citrus juices
- Take a prescribed potassium supplement
Possible side effects of diuretics include:
- Leg cramps
- Dizziness or light-headedness
- Incontinence (accidental urine leakage)
- Gout (a type of arthritis)
- Skin rash
Note: Urinating more often is not a side effect; it is the intended result of the diuretic.
Digitalis strengthens each heartbeat, allowing the heart to pump more blood. This may improve your loved one’s ability to exercise. Prescribed as digoxin or Lanoxin, digitalis is taken daily by many heart patients.
Possible side effects of digitalis include:
- Loss of appetite
- Mental confusion
- Blurred or yellow-colored vision
- Rapid, forceful heartbeat (palpitations)
This drug widens blood vessels, easing blood flow.
Possible side effects of hydralazine include:
- Rapid heartbeat
- Joint pain
Nitrates (usually nitroglycerin and isosorbide) increase blood flow to the heart muscle and make it easier for the heart to work. Nitrates can relieve most anginal discomfort very quickly. Nitrates are taken either as tablets placed under the tongue, tablets that are swallowed, a patch worn on the skin, or a cream applied to the skin.
Nitrate tablets, cream, and patches all have a limited shelf life. Ask your pharmacist to explain the expiration dates for nitrates. Nitrate cream and patches are for maintenance therapy only. If your loved one is using a nitrate patch or cream, he or she should still use nitrate tablets if he or she has anginal discomfort.
Your loved one should take one nitroglycerin tablet as soon as he or she feels any anginal discomfort, or chest pain. If the discomfort does not go away in 5 minutes, he or she should take a second tablet. If the discomfort does not go away after 5 more minutes, take a third tablet. If the discomfort has not gone away after taking three nitrate tablets in 15 minutes, your loved one should go to the hospital immediately. Persistent discomfort that doesn’t go away could be a sign that your loved one is having a heart attack.
Possible side effects of nitrates include:
- Light-headedness (Tablets should be taken while sitting down)
Your pharmacist is a good resource for information about medications. Ask if any drugs that your loved one is currently taking will interact with certain foods or with other drugs, including nonprescription ones. Your pharmacist also can help you and your loved one understand product package inserts and label instructions.
Remember, if your loved one does experience any medication side effects, he or she should tell the doctor about them as soon as possible. It’s possible that the doctor may be able to try a different prescription that will ease your loved one’s discomfort. Under no circumstances, however, should your loved one stop taking any prescribed medication unless a doctor tells him or her to do so. Some side effects can be annoying, or even painful, but the medication is intended to manage your loved one’s heart problem, and failure to take the medication as prescribed could lead to more serious heart problems in the future.
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Adapted from Living With Heart Disease: Is It Heart Failure? AHCPR Publication No. 94-0614, developed by the United States Agency for Health Care Policy and Research.
Facts About Heart Failure, NIH Publication No. 95-923, developed by the United States National Institutes of Health National Heart, Lung, and Blood Institute.