Tuesday, 13 January 2015

Common Cardiac Medications And Their Side Effects

Side Effects and Notes
ACE inhibitors
converting enzyme
(angiotensin II receptor
These medications block stress
hormones and relieve stress
on the heart’s pumping action.
They improve symptoms and
reduce hospitalizations
for patients with heart failure.
ACE inhibitors:
benazepril (Lotensin)
captopril (Capoten)
enalapril maleate (Vasotec)
lisinopril (Prinivil, Zestril)
quinapril (Accupril)
ramipril (Altace)
candesartan cilexetil (Atacand)
eprosartan mesylate (Teveten)
irbesartan (Avapro)
losartan (Cozaar)
telmisartan (Micardis)
valsartan (Diovan)
Side effect:
A dry, non-productive cough is
a common side effect of ACE
Don’t use potassium supplements
or salt substitutes without first
asking your healthcare providers.
(heart rhythm
These control irregular
heartbeats — and maintain a
normal heart rate and rhythm.
amiodarone (Cordarone)
disopyramide phosphate (Norpace)
dofetilide (Tikosyn)
flecainide (Tambocor)
mexiletine HCl (Mexitil)
procainamide (Procan, Pronestyl)
propafenone HCl (Rythmol)
propafenone HCI SR (Rythmol SR)
quinadine glucomate (Quinaglute)
sotalol (Betapace, see beta blockers)
tocainide HCl (Tonocard)
As with any medication, take
antiarrhythmics exactly as ordered.
If you’re taking some of these
medications, you’ll need ongoing
monitoring by your healthcare
If you’re taking an extended-release
tablet, be sure to swallow the pill
whole don’t break, chew, or
crush it.
Anticoagulants and
platelet inhibitors
(“blood thinners”)
These cause your blood to
take longer to clot, which can
reduce the risk of strokes and
heart attacks that can occur
when blood clots get stuck in
small blood vessels.
dalteparin sodium (Fragmin)
enoxaparin (Lovenox)
fondaparinux (Arixtra)
heparin sodium
warfarin (Coumadin)
Platelet inhibitors:
cilostazol (Pletal)
clopidogril bisulfate (Plavix)
dipyramidamole (Persantine)
prasugrel (Effient)
ticlopidine (Ticlid)
Side effect:
Call your healthcare provider if you notice bleeding
from your gums, or blood in your urine or stools.
Make sure your provider knows about all other
medication you’re using. Many substances 
including over-the-counter drugs and herbal
supplements should not be used while you’re
taking some blood thinners.
If you’re taking some of these medications, you’ll need
ongoing monitoring by your healthcare provider.
If you miss a dose, do NOT take extra the next time
to “catch up.”
Be consistent with your diet, especially foods rich
in vitamin K (see chapter 8).
Keep regular appointments to have your blood
tested to make sure it’s clotting at the right level.
Depending on the type of test, it’s called a PT
(or PT/INR) or a PTT test.
(blood pressure medication)
These are commonly used to
treat high blood pressure by
relaxing and widening
blood vessels.
clonidine HCl (Catapres, Dixarit)
doxazosin mesylate (Cardura)
hydralazine HCI
methyldopa (Aldomet)
phenoxybenzamine HCl
phentolamine mesylate
prazosin HCl (Minipress)
terazosin HCl (Hytrin)
As with any drug, don’t stop using blood
pressure medication without first asking your
healthcare provider.
Beta blockers
These medications are often
prescribed to treat angina, high
blood pressure, and irregular
heart rhythms. They:
Block stress hormones and
relieve stress on the heart’s
pumping action
Relax the blood vessels so
blood can move more easily
Improve the heart’s function
Reduce symptoms and
lessen the chance of future
acebutolol HCl (Sectral)
atenolol (Tenormin)
betaxolol (Kerlone)
bisoprolol (Zebeta)
carvedilol (Coreg)
labetalol HCl (Normodyne, Trandate)
metoprolol succinate (Toprol XL)
metoprolol tartrate (Lopressor)
nadolol (Corgard)
nebivolol (Bystolic)
pindolol (Visken)
propranolol HCl (Inderal)
sotalol (Betapace)
timolol maleate (Blocadren)
Side effects:
In some people, beta blockers can cause drowsiness.
Call your healthcare provider right away
if you have any of these side effects:
Chest pain (may be related to your disease
and not a side effect)
Fainting or severe dizziness
Slow, fast, or irregular heartbeat
Swelling of your feet or ankles
Unusual bleeding or bruising
Unusual weight gain
Wheezing or trouble breathing
Calcium channel blockers
These are commonly used to treat
high blood pressure, coronary
artery spasms, and angina. They
restrict the normal flow of calcium
into the cells of the heart and
blood vessels, which discourages
smaller vessels from narrowing
and going into spasm, and also
reduces the heart’s workload and
need for oxygen.
amlodipine besylate (Norvasc)
bepridil (Vascor)
diltiazem HCl (Cardizem, Dilacor, Tiazac)
felodipine (Plendil)
isradipine (DynaCirc)
nicardipine HCl (Cardene)
nifedipine (Adalat, Procardia)
nisoldipine (Sular)
verapamil HCl (Calan, Covera, Isoptin)
Side effect:
Calcium channel blockers can cause
swelling in your feet and legs.
Digitalis glycosides
These strengthen the heart
muscle, treat irregular heart
rhythms, and improve
exercise tolerance.
digoxin (Lanoxin)
Many drugs  including some
antacids and other over-the-counter
medications  can affect how
digitalis works in your body. As always,
make sure your healthcare provider
knows about all the medications and
supplements you’re taking.
Diuretics (“water pills”)
These help rid your body of excess
fluid and salt. They are often
prescribed for high blood pressure
and congestive heart failure.
amiloride (Midamor)
bumetanide (Bumex)
chlorothiazide (Diuril)
ethacrynic acid (Edecrin)
furosemide (Lasix)
hydrochlorothiazide (Esidrix,
HydroDIURIL, Microzide, Oretic)
indapamide (Lozol)
metolazone (Mykrox, Zaroxolyn)
triamterene (Dyrenium)
Aldosterone receptor
eplerenone (Inspra)
spironolactone (Aldactone)
Combination products
amiloride and
spironolactone and
hydrochlorothiazide (Aldactazide)
torsemide (Demadex)
triamterene and
Side effects:
Diuretics can cause extreme
weight loss, lightheadedness, or
increased blood pressure.
Diuretics make you urinate more.
You may want to take diuretics
early in the morning and/or
afternoon. This will help you avoid
having to get up at night to urinate.
Since the use of some diuretics
can cause loss of potassium from
the body, potassium supplements
are often prescribed with diuretics.
See “potassium supplements”
later in this table.
Lipid medications
(blood cholesterol
lowering agents,
The medications in this
category work in different
ways. Depending on which
one you’re taking, lipid
medications can lower your
levels of cholesterol, LDL, and
triglycerides — as well as
treat abnormally low levels
of HDL cholesterol.
atorvastatin calcium (Lipitor)
fluvastatin sodium (Lescol)
lovastatin (Mevacor)
pravastatin sodium (Pravachol)
rosuvastatin (Crestor)
simvastatin (Zocor)
fenofibrate (Tricor)
gemfibrozil (Lopid)
Bile acid sequestrants
colesevelam HCl (Welchol)
cholestyramine (Questran)
colestipol HCl (Colestid)
Other lipid medications
niacin (Niaspan, Nicolar)
Side effect: Call your healthcare provider
right away if you have any unexplained muscle
pain, weakness, or cramps.
The cornerstone of treating high blood
cholesterol is a low-fat, low cholesterol diet.
Drug therapy only works when you also follow
dietary guidelines.
With many lipid medications, you can’t eat
grapefruit or drink grapefruit juice. Ask your
healthcare provider.
Take your statin medication with your evening
meal or at bedtime.
If you take fenofibrate (Tricor) AND also take
cholestyramine (Questran), colestipol (Colestid),
or colesevelam HCl (Welchol)  take your dose
of fenofibrate at least 1 hour before, or 4 to 6
hours after, these other medicines.
Nitrates and other
These are commonly used to
prevent, reduce, or relieve
angina pain. They work by
relaxing blood vessels and
increasing the supply of blood
and oxygen to the heart —
while reducing the blood
pressure that your heart has
to pump against.
Nitrates (nitroglycerin)
oral nitroglycerin (Dilatrate-SR,
Imdur, ISMO, Isordil, Monoket)
nitroglycerin ointment
(Nitro-Bid Ointment, Nitrol)
nitroglycerin skin patches
(Deponit, Minitran, Nitro-Dur,
nitroglycerin sublingual tablets
(Isordil, Nitrostat, Nitrogard, Sorbitrate)
other nitroglycerin tablets,
capsules, and sprays (Nitro-Bid,
Nitrocine, Nitroglyn, Nitrolingual,
Nitrong, Nitrostat)
Other anti-anginals
ranolazine (Renexa)
Notes about nitrates:
If your nitroglycerin pills come with instructions
to dissolve them under your tongue, be sure to
do this. Do NOT swallow them. The drug won’t
work if it’s in your stomach.
Store nitroglycerin in its original bottle, in a
dark place. This helps preserve its potency.
It’s important to replace your nitroglycerin
pills every three months, because they lose
their effectiveness.
Notes about ranolazine (Renexa):
Ranolazine has many drug interactions.
Be sure to tell your doctor about all other
medications you are taking.
Do NOT take ranolazine if you have severe
liver disease.

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