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Medicines That Make Heart Failure Worse

There are many medicines that you'll need to avoid when you have heart failure. Some are over-the-counter drugs that you can buy without a prescription. Others are drugs that a doctor may prescribe.

Do not start taking any of the medicines listed in the table below unless your doctor says it is okay and he or she knows that you have heart failure. If your heart failure is mild, you may be able to use some of the medicines for a short time, but it's very important to ask your doctor first.

If you are already taking a medicine on the list below, be sure to ask your doctor or pharmacist if it is okay to take it.

Medicines you may need to avoid

Over-the-counter medicines you may need to avoid (talk to your doctor or pharmacist)

Prescription medicines you may need to avoid (talk to your doctor or pharmacist)

Pain relievers called NSAIDs

  • Ibuprofen, such as Advil and Motrin
  • Naproxen, such as Aleve
  • Aspirin, such as Bayer
    • If your doctor has told you to take a low-dose aspirin every day for your heart problems, it's probably okay to take it. Low-dose aspirin can help prevent blood clots and may prevent a stroke or a heart attack.
    • Higher doses of aspirin may make your heart failure worse. Do not take aspirin for pain, such as from headaches or arthritis. Use acetaminophen, such as Tylenol, instead.

Pain relievers

  • Celecoxib
  • Etodolac
  • Indomethacin
  • Ibuprofen
  • Ketoprofen
  • Nabumetone
  • Naproxen
  • Piroxicam
  • Sulindac

Cold, cough, flu, or sinus medicines

  • Be sure to check the label. Do not take medicines that contain pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline, such as:
    • Sudafed.
    • Nose sprays (decongestants), such as Afrin and Dristan.
    • Herbal remedies, such as ma huang and Herbalife.
  • Make sure your cough and cold medicines don't contain aspirin or ibuprofen.

Antiarrhythmics

  • These are drugs used to treat a fast or uneven heart rhythm. You may need to avoid the following:
    • Disopyramide
    • Dofetilide
    • Flecainide
    • Procainamide
    • Propafenone
    • Quinidine
    • Sotalol

Antacids or laxatives that contain sodium

  • Check the label for sodium or saline. Examples include:
    • Antacids, such as Alka-Seltzer.
    • Laxatives, such as Fleet Phospho-Soda.

Calcium channel blockers

  • People with a certain kind of heart failure may need to avoid the following medicines:
    • Diltiazem
    • Verapamil
  • If you need to take a calcium channel blocker for another health problem, such as high blood pressure, your doctor will watch your health carefully.
 

Certain diabetes medicines

  • Most diabetes drugs are safe to take, but avoid the following:
    • Metformin
    • Rosiglitazone and pioglitazone1
 

Certain antibiotics

  • Some antibiotics may interfere with how your body uses the medicine digoxin. If you take digoxin, talk with your doctor before taking antibiotics.

Citations

  1. Kaul S, et al. (2010). Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.
By Healthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer Margaret Hetherington, PHM, BsC - Pharmacy
Last Revised April 26, 2012

Last Revised: April 26, 2012

Author: Healthwise Staff

Medical Review: Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & Margaret Hetherington, PHM, BsC - Pharmacy

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