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Below is a list of common heart medication you may be prescribed and their intended purpose.

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Medications

STATINS

Simvastatin, Atorvastatin, Pravastatin, Rosuvastatin

What can it do for me?

“Statins” lower your risk of having a heart attack in two ways. First, they stabilise any existing plaque so that it is less likely to crack and cause a blood clot that can block the artery, causing a heart attack. Second, they lower the amount of cholesterol circulating in the blood, which helps to prevent plaque from forming.

How does it do that?

They can reduce inflammation in the blood vessels and stabilise plaques. They also reduce the amount of cholesterol in your blood  by blocking the action of a chemical in the liver that is necessary for making cholesterol. Statins work best in combination with a healthy diet.

What’s the catch?

Side effects might include: stomach upsets, muscle weakness or aches, diarrhea or constipation

What checks do I need?

You may have occasional cholesterol checks and further tests may be required if you have adverse effects.

What should I look out for?

You may have to take your statin at night. Very rarely a serious muscle problem can develop. If you notice NEW muscle pain or weakness or brown urine, stop taking the statin and tell your doctor immediately (within one day).

Grapefruit and grapefruit juice should not be consumed when you are taking a statin. There is a chemical in grapefruit and grapefruit juice that interferes with the absorption and metabolism of statins, calcium channel blockers and some other drugs too. Levels of these drugs can become too high and cause unwanted side effects.

Statins interact with several commonly used medication, including some antibiotics. As always, tell the doctor treating you that you are taking a statin.

What about other cholesterol lowering medications?

Although there are other medicines that lower cholesterol, statins are the most effective at reducing the chance of further heart attacks and are the most commonly used.

BETA-BLOCKERS

Bisoprolol, Carvedilol, Metoprolol, Atenolol, Sotalol, Celiprolol, Labetalol

What can it do for me?

Reduce the chance of a heart attack. Lower your blood pressure and heart rate and helps prevent angina. If you have heart failure it can stop it getting worse.

How does it do that?

It prevents adrenaline speeding up your heart which lowers your blood pressure and your heart rate.

What’s the catch? 

You may feel feel tired and/or have cold feet and hands. Other effects might include nightmares, dizziness, skin rash, light-headedness or pins and needles.  You may feel worse to start with but this usually goes away within a few weeks. If you have erection problems after starting this medication, talk to your doctor.

What checks do I need?

Your blood pressure (BP) and heart rate should be monitored by your GP/nurse at your visits, and more frequently if your dose changes.

What should I look out for?

You will need to start on a low dose and then gradually increase. This will be organised by your doctor. Any change of dose should be made slowly as your doctor recommends. It is important not to stop beta-blockers suddenly or run out of medication.

Why can’t I stop taking it – even for one day?

Do not stop taking a beta-blocker suddenly without first consulting a doctor. When you take a beta-blocker regularly, the body becomes used to it. So, suddenly stopping taking it can sometimes cause problems such as palpitations, a rise in blood pressure, or a recurrence of angina pains. If you do need to stop taking a beta-blocker then your doctor may advise a gradual reduction in dose.

ACE INHIBITORS

Cilazapril, Quinapril, Enalapril, Captopril, Lisinopril

What can it do for me?

Reduces blood pressure. Helps prevent heart failure getting worse and can help reduce symptoms such as breathlessness or swelling caused by poor pumping of your heart.

How does it do that?

It relaxes your arteries, making it easier for your heart to pump blood around your body.

What’s the catch?

The first dose can cause a drop in blood pressure (especially if you take a diuretic) which can make you feel dizzy or faint. Because of this your doctor will prescribe a lower dose initially.  May cause an irritating cough and metallic taste.

What checks do I need?

Blood pressure monitoring and other blood tests (for kidney function and potassium).

What should I look out for?

Difficulty breathing, weakness, confusion, palpitations, sudden nervousness, and/or swelling which may mean your potassium levels are too high. Other side effects might include: swollen face, lips or mouth, sudden wheeziness or problems breathing, a rash, itching. These can indicate a serious allergic reaction. Report these immediately to your doctor.

If you suspect you have side effects, you should talk to your doctor as there are alternative medication available.

What are alternatives to ACE inhibitors if these aren’t right for me?

The commonly used alternative to ACE inhibitors are medications called Angiotensin ll Receptor Blockers

Names: candesartan, losartan

Works similarly to an ACE inhibitor but less likely to cause a cough.

THIAZIDE DIURETICS

Bendrofluazide, Chlorthalidone, Indapamide,  Hydrochlorothiazide

What can it do for me?

Reduces blood pressure.

How does it do that?

By acting in the blood vessels and kidneys.

What’s the catch?

Can change the level of potassium and sodium in your blood. Some side effects may be: muscle cramps, tiredness, dark urine, constipation, dry mouth, bruising easily, diarrhoea or constipation. Can cause gout. They do not usually cause excessive urination (peeing a lot)  like other diuretics such as furosemide or bumetanide.

What checks do I need?

Blood tests for kidney function, sodium and potassium.

What should I look out for?

Dizziness, confusion or dehydration.

CALCIUM CHANNEL BLOCKERS

Felodipine, Amlodipine, Diltiazem, Nifedipine, Verapamil

What can it do for me?

Reduces blood pressure.

Diltiazem can also help control heart rate and prevent angina

How does it do that?

Calcium channel blockers keep calcium from entering the muscle cells of the heart and blood vessels. This widens your arteries (large blood vessels) and reduces your blood pressure.

What’s the catch?

Constipation, headaches, swollen ankles, tiredness are the most common adverse effects.

What checks do I need?

Blood pressure monitoring

Heart rate should be monitored if you are taking diltiazem

What should I look out for?

Grapefruit or grapefruit juice should not be consumed while taking diltiazem. There is a chemical in grapefruit and grapefruit juice that interferes with the absorption and metabolism diltiazem, statins and some other drugs too. Levels of these drugs can become too high and cause unwanted side effects.

ANTI PLATELET AGENTS

Aspirin

What can it do for me?

Reduce the chance of having a heart attack or stroke caused by blood clots. If you do have one it can limit any damage to your heart. It can also protect you from stroke.

How does it do that? Blood clots cause heart attacks. At a low dose (75 – 150mg/day) aspirin stops your blood clotting so easily. It also reduces inflammation in the arteries that can trigger a heart attack.

Doses of more than 150mg per day are not recommended for the prevention of heart attack and stroke. Although larger doses of 300 – 600 mg  are used short term for pain relief these doses are not need for the antiplatelet action and cause unnecessary gastric irritation.

What’s the catch?

You may bruise more easily and aspirin can, despite the low dose, cause gastric irritation and bleeding, especially if taken with some other medications.

What checks do I need?

None.

What should I look out for?

If you get stomach pain, ringing in your ears, severe headache, pass black tarry stools contact your doctor.

It is best to take aspirin after you’ve eaten food, as it can reduce the chance of it causing stomach irritation.

Aspirin should not generally be taken if you are taking warfarin, some pain medicines or anti-inflammatory medicines. Always show the pharmacist what you are taking. If you have been given both, ask your doctor why.

If I can’t take aspirin, is any other anti-platelet medication available?

Other anti-platelet medications may be used either with or instead of aspirin. Your doctor will decide if these are suitable for you.

These may include Dipyridamole, Clopidogrel or Ticagrelor.

ANTITHROMBOTIC: ANTI-COAGULANT

Warfarin, Dabigatran

What can it do for me?

Help prevent a recurrence of heart attack or stroke. You are likely to be taking one of these medications if you have atrial fibrillation (AF).

How does it do that?

It reduces blood clotting

What’s the down side?

It has to be very carefully monitored; taking too much can be dangerous. Because it reduces ‘clotting’ if you cut yourself you will bleed for longer.

If you are taking aspirin and warfarin you are at more risk of bleeding. Check with your doctor or pharmacist before starting or stopping any medication you are already taking.

What checks do I need?

Regular blood tests are required at suitable intervals, which vary for different individuals.

If you are taking warfarin your doctor will discuss this with you.

What should I look out for?

Blood in your urine or motions. Any unusual signs of bruising, let your doctor know immediately. Many other medication or supplements can alter how warfarin works and it is important to tell your doctor or nurse about anything else you take (including herbal or complimentary treatments). Some foods can alter how warfarin works, your nurse, pharmacist or doctor can explain.

NITRATES

Glyceryl Trinitrate (spray and tablets), Isosorbide Mononitrate

What can it do for me?

There are two types, long acting and short acting.

Long acting nitrates reduce the severity of angina.

Short acting nitrates reduce angina pain once it starts.

How does it do that?

Short acting nitrates (spray or pill form) temporarily open up your arteries to let more blood flow through and should stop angina pain. The longer acting medication allow the arteries to relax for a long period of time and helps prevent angina.

What’s the down side?

All nitrates can give you a headache. For long acting nirates, starting on a lower dose can help and often goes within one or two weeks of use.

What checks do I need?

None.

What should I look out for?

Check expiry date on GTN spray regularly, especially if you do not use it often. If your angina attacks increase in frequency or severity, tell your doctor. If angina lasts for more than 10-15 minutes, follow the angina action plan (link to AAP)

Never use PDE-5 inhibitors such as Sildenafil (Viagra, Avigra), Tadalafil (Cialis) and Vardenafil (Levitra) if taking nitrate medication. Learn more about sex and relationships after a heart attack.

 What’s the best way to use my GTN spray?

Sit down, spray once or twice under your tongue, wait five minutes and repeat if your still feeling pain. If symptoms persist then call 111.

Print off this angina action plan and pin it on your fridge or other prominent place – let people you live or work with know what to do.

Continue the journey

Making it a habit
Discover how to maintain new healthy lifestyle changes
Read more
Treatment for a Heart Attack
Once diagnosis of a heart attack is confirmed, medical staff can start treatment
Read more

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