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Medicines that may make heart failure symptoms worse

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By Robin Parks, MS

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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.

Prescription NSAIDs

  • Celecoxib (Celebrex)
  • Etodolac (Lodine)
  • Ibuprofen (prescription-strength Motrin)
  • Indomethacin (Indocin)
  • Ketoprofen
  • Nabumetone (Relafen)
  • Naproxen sodium (Anaprox)
  • Piroxicam (Feldene)
  • Salsalate (Disalcid, Salsitab)
  • Sulindac (Clinoril)

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:
    • Quinidine (Quinaglute, Quinidex Extentabs)
    • Disopyramide (Norpace)
    • Procainamide
    • Flecainide (Tambocor)
    • Sotalol (Betapace AF)
    • Propafenone (Rythmol)
    • Dofetilide (Tikosyn)

Antacids or stool softeners

  • Do not take ones that contain sodium, such as Alka-Seltzer or Dulcolax.

Calcium channel blockers

  • People with a certain kind of heart failure may need to avoid the following medicines:
    • Diltiazem (Cardizem, Dilacor XR, Taztia, Tiazac)
    • Verapamil (Calan SR, Isoptin SR)
  • 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 you may need to avoid the following:
    • Thiazolidinediones—rosiglitazone (Avandia) and pioglitazone (Actos)
    • Metformin (Glucophage)
 

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.

Credits

Author Robin Parks, MS
Editor Kathleen M. Ariss, MS
Editor Marianne Flagg
Associate Editor Pat Truman, MATC
Associate Editor Terrina Vail
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Last Updated August 25, 2008
Last Updated: 08/25/2008