What heart failure medications are available?

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Angiotensin II receptor blockers (ARBs): Angiotensin II receptor blockers (ARBs) may be used in patients who are unable to tolerate ACE inhibitors due to chronic cough, low blood pressure, or edema. These drugs, which help open (dilate) the arteries, are similar to ACE inhibitors, make it easier for the heart to pump blood, and may improve heart failure symptoms. Ongoing studies are investigating the use of ACE inhibitors with the use of ARBs in some patients with heart failure.
Angiotensin II receptor blockers generally are taken once a day, and they usually do not cause significant side effects. Rarely, they can impede kidney function.

Diuretics (water pills): The buildup of fluid is usually treated with a diuretic. This medication causes the kidneys to remove fluid and salt from the bloodstream, reducing the amount of liquid blood in circulation. With a lower volume of blood, your heart does not have to work so hard. The number of red and white blood cells is not changed. The end result is an improvement of your ability to breathe and also a lessening of the swelling. Most of these drugs tend to remove potassium from the body.

Digoxin (Lanoxin): This drug improves the pumping ability of the heart, causing it to pump more forcefully. Many drugs have been tried to improve pumping action of the heart, but only digoxin has ever been successful in this approach to treating heart failure. Digoxin is an old medicine, used for hundreds of years, that is derived from the foxglove plant. This medication is also used to control the rhythm of the heart. The concentration of this drug in the blood is very important. If it is too low, the drug won't work; if it is too high, you could have unpleasant, even dangerous, side effects. Therefore, you will have to have frequent blood tests until the dose is exactly right for you.

Beta-blockers: These drugs slow down heart rate and lessen the strain on the heart. A beta-blocker medicine, such as bisoprolol or carvedilol, is often prescribed in addition to an ACE inhibitor and diuretic. Beta-blockers have a protective effect on the heart muscle. A low dose is started at first, and then increased every few weeks until a regular dose is reached. They decrease the amount of work the heart has to do. They also lower blood pressure. They work by blocking the action of chemical messengers that tell the heart to beat faster as a compensation for its impaired pumping ability. They are often used in combination with other drugs such as diuretics and ACE inhibitors.

Anti-arrhythmics: These medications control the rhythm of the heart and prevent the heart from beating too fast, a type of rhythm disorder called tachycardia. Some common examples are amiodarone (Cordarone) and flecainide (Tambocor).

Nesiritide (Natrecor): This medication is used to treat heart failure in people in the hospital. This is a new medication produced by recombinant DNA technology. It is also known as B-type or beta natriuretic peptide (BNP). It is given by IV to help stabilize people whose heart failure is suddenly worse. The effect of the medication is similar to vasodilators but also produces an effect similar to diuretics as well.

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