Heart Failure - Taking Medications

© Excerpted by permission of SmithKline Beecham Pharmaceuticals and Roche Pharmaceuticals.

Patients with heart failure (HF) sometimes need to take several medications. They can do wonders in helping you feel better and improving your health. On the other hand, the more medications you take, the easier it is to make a mistake - like skipping a dose. In fact, forgetting to take medication properly is one of the most common reasons people with HF have to be hospitalized.

No matter what medications you take, you’ll get best results if you understand what you’re taking and why.

What Am I Taking?

Here are some of the medications more commonly used in managing HF and some important facts about each:

ACE Inhibitors

What They Do:

These medications are considered “vasodilators”, because they dilate, or widen, blood vessels. With this action, ACE inhibitors increase the flow of blood, reducing the amount of work the heart has to do. They also reduce substances in the body that damage the heart.

Benefits

ACE inhibitors help to keep you out of the hospital, improve your chances of living longer and make you feel better.

Some things to watch for:

Dizziness or light-headedness. You may be especially prone to this if you’re also taking a diuretic (water pill). If it persists, call your doctor.

Swelling of the tongue or face; skin rash, with or without itching. Don’t attempt to treat this yourself. Call your doctor right away.

Signs of too much potassium in the body. Confusion; heart beat that skips; nervousness; numbness or tingling in the hands, feet, or lips; weakness or heaviness of the legs. Call your doctor right away.

Cough. If this persists or is severe, call your doctor.

Diuretics

What They Do:

Diuretics are often called “water pills”. This is because they increase the amount of urine the body produces, helping get rid of extra fluids and sodium. This helps decrease the amount of fluid that collects in the feet, lungs, and other areas in some people with HF.

Some types of diuretics can cause your body to lose potassium, an important element in your blood. For this reason, your doctor may also want you to take a potassium supplement.

Benefits:

Diuretics are essential medications to relieve fluid buildup in your body. When they reduce extra fluids, you will probably feel better. In addition, other medications that slow down HF development work better when you don’t have extra water weight.

Some things to watch for:

Nighttime urination. If you are having sleeping problems because you have to urinate often during the night, ask your doctor if you can take your diuretic earlier.

Dizziness or light-headedness when getting up from a sitting or lying position. If this problem persists or gets worse, call your doctor.

Signs of potassium loss. Dryness of mouth; increased thirst; heartbeat that skips; mood or mental changes; muscle cramps or pain (especially in the legs); nausea or vomiting; unusual tiredness or weakness; weak pulse. Call your doctor immediately.

Skin rash. Call your doctor right away.

Digoxin/Digitalis

What It Does:

Digoxin, also known as digitalis, helps the heart pump more strongly and can help control the rhythm of the heartbeat. This helps improve blood circulation and reduce swelling of the feet and lower legs. However, the dose of digoxin needs to be precise, and requires periodic blood monitoring to ensure appropriate dosaging.

Benefits:

Digoxin can help you feel better and function better on a daily basis. Taking digoxin may also help you stay out of the hospital.

Some things to watch for:

Signs of a too-high digoxin dose. Loss of appetite; nausea or vomiting; lower stomach pain; diarrhea; extreme tiredness or weakness; slow or irregular heartbeat; blurred vision or halo vision (yellow, green or white “halos” seen around objects); confusion; dizziness; fainting. If you experience any of these, call your doctor immediately.

Skin rash or hives. This side effect is rare but needs a doctor’s attention right away.

Keeping Track

Can you take your medications in the morning, with food? Or must they be taken on an empty stomach? Whatever your schedule, it’s important that you follow your doctor’s instructions exactly. Make sure you know what you’re taking, how it works, and how to best take it - and if you’re unsure about anything, just ask!

Don’t skip your medications because you’re feeling good. Most HF medications need to be taken regularly to keep you healthy.

Don’t “stretch out” your medications to save money. You must take the full amount to get the full benefits. Talk with your doctor; you may be able to get medications at a reduced cost.

Helpful Ways to Remind Yourself

If you need to take several medications a day, take a few minutes to plan a schedule (your doctor or nurse can help you). Keep copies of the schedule handy, in places you’re likely to be when it’s time to take a dose (say by the television, in your desk at work, and in the kitchen). Here are some other good reminders:

Try to take your medications at the same time you perform other regular activities (such as brushing your teeth or watching the evening news).

Set an alarm clock or timer to ring when it’s time to take your medication.

Use a divided pillbox with sections for different times of the day. Some pillboxes even have a built-in alarm clock.

Mark your calendar several days or a week before it’s time to get refills of your medications. You don’t want to miss a single dose of a medication, so advance planning is important.

Travel Wise

Going on a trip? Here are some tips to keep you feeling your best - and on track with your medications:

Make sure you’re in good travel shape. If you’ll be walking a lot on your trip, start a walking program before you leave. Make sure you’ve gotten plenty of rest beforehand.

Don’t weigh yourself down with luggage and tire yourself out. Use a cart or suitcases on wheels, and get help from a porter.

Don’t risk losing your medications. Pack one set with you in a carry-on bag and an extra set in your luggage. On longer trips, take an extra week’s worth of medications - and copies of your prescriptions, too, in case you need a refill.

Tote a small water bottle with you in case you need to take your medications en route. Bring along some low-sodium snacks, if the medication requires a full stomach.

When traveling, your feet and ankles may swell. Wear comfortable shoes and socks. Try to elevate your feet above chest level when you arrive and get a chance to rest.

When flying, walk up and down the aisles to stretch your legs and get your circulation going. (This can help reduce foot and ankle swelling, too).

Keep up your exercise routine on your trip. Ask your hosts, or the hotel’s front desk, if there is a safe walking path or a health club nearby.

If You Miss a Dose

Everyone makes mistakes, so make sure you know what to do if you miss taking your medication. Your doctor can give you instructions; use the Medications Worksheet to record them. Don’t try to make up for a missed dose by taking two doses at once, unless your doctor says it’s okay.

Side Effects/Reactions With Other Medications

Medications are powerful weapons against HF, but they can also have other, unwanted effects. Most of these side effects are harmless and clear up as your body adjusts to the medication, but some can be dangerous. Ask your doctor or pharmacist about side effects for each medication you take.

There are some side effects that require immediate attention. Your doctor or pharmacist will be able to tell you what they are.

Also important to watch for are reactions with other medications you might be taking. Even something that seems harmless, such as nonprescription cold tablets or plain asprin, can be dangerous. Make sure your doctor and pharmacist know all the medications you take, including the nonprescription types, so you can avoid these reactions.

Putting It All Together

Taking medication is one of the simplest things you can do to manage your HF - but sometimes, it can seem complicated. The more you know about your medications and how they work, the easier it will be for you to stay on track. Your doctor, nurse, and pharmacist can help you every step of the way; whenever you have a question or problem, don’t hesitate to ask them.

 

© Excerpted by permission of SmithKline Beecham Pharmaceuticals and Roche Pharmaceuticals.