Medications

You will likely be taking medications following your heart attack. Your physician has carefully chosen the type of medications and dosage you need based upon your present condition. It is important to recognize that not everyone will be taking the same medications. Your blood pressure, any abnormal heart rhythm, and the extent of damage to the heart muscle, will influence your doctor’s decision.

This section provides a brief outline of the medications most commonly used and their role in treating heart disease. If your medication is not listed or you want more detailed information about your specific medications, ask your pharmacist.

Commonly Prescribed Cardiac Medications

This video was developed by two Ottawa Heart Institute Clinical Pharmacists. It contains information on common medications for the heart and how to safely manage your medications.

Types of Medication

Type of Medicine Names of Medication How Medication Works Potential Side Effects
Antiplatelets ASA (Aspirin®, ECASA)
Clopidogrel (Plavix®)
Prasugrel (Effient®)
Ticagrelor (Brilinta®)
  • Helps prevent blood clots in injured coronary arteries
  • Helps prevent blood clots on stents (clopidogrel, prasugrel)
  • Decreases the risk of future heart attacks
  • Increased risk of bleeding & bruising
  • Stomach upset (nausea, diarrhea, heartburn)
ACE Inhibitors
(Angiotensin Converting Enzyme Inhibitors)		 Benazepril (Lotensin®)
Captopril (Capoten®)
Cilazapril (Inhibace®)
Enalapril (Vasotec®)
Fosinopril (Monopril®)
Lisinopril (Zestril®, Prinivil®)
Perindopril (Coversyl®)
Quinapril (Accupril®)
Ramipril (Altace®)
Trandolapril (Mavik®)
  • Relaxes blood vessels and lowers blood pressure
  • Decreases the risk of future heart attacks
  • Maintains the heart’s shape promoting normal function
  • Cough
  • Dizziness, lightheadedness
  • Increased potassium level in blood
  • Swelling of lips/face/throat (rare) – Call 911
Beta Blockers Acebutolol (Rhotral®, Sectral®)
Atenolol (Tenormin®)
Bisoprolol (Monocor®)
Carvedilol (Coreg®)
Labetalol (Trandate®)
Metoprolol (Betaloc®, Lopressor®)
Nadolol (Corgard®)
Pindolol (Visken®)
Propranolol (Inderal®)
Timolol (Blocadren®)
  • Lowers blood pressure and heart rate
  • Helps prevent angina
  • Improves heart function
  • Slows down irregular heart rhythms
  • Decreases the risk of future
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing
Cholesterol Lowering Medications Statins
Atorvastatin (Lipitor®)
Lovastatin (Mevacor®)
Pravastatin (Pravachol®)
Rosuvastatin (Crestor®)
Simvastatin (Zocor®)
  • Lowers LDL (“bad”) cholesterol
  • Decreases the risk of future heart attacks
  • Constipation, gas
  • Indigestion
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Bezafibrate (Bezalip SR®)
Fenofibrate (Lipidil EZ®, Lipidil Micro®, Lipidil Supra®)
Gemfibrozil (Lopid®)
  • Lowers triglycerides
  • Rash
  • Stomach upset (nausea, vomiting, diarrhea, gas)
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Niacin (Niaspan®)
  • Increases HDL (“good”) cholesterol
  • Lowers triglycerides
  • Flushing
  • Mild decrease in liver function
Ezetimibe (Ezetrol®)
  • Usually used with a statin to lower LDL (“bad”) cholesterol
  • Diarrhea
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Cholestyramine (Questran®)
Colestipol (Colestid®)
  • Mildly lowers LDL (“bad”) cholesterol
  • Constipation
  • Nausea
  • Bloating
Nitrates Isosorbide Dinitrate (ISDN, Isordil®)
Isosorbide Mononitrate (Imdur®)
Nitroglycerin spray (Nitrolingual®)
Nitroglycerin patch (NitroDur®, Minitran®, Trinipatch®)
  • Improves blood flow to the heart by relaxing the blood vessels
  • Helps prevent angina (patch and tablets)
  • Stops angina (spray)
  • Headache
  • Skin irritation at application site (patch)
  • Lightheadedness (spray)
Angiotensin II Receptor Blockers (ARBs) Candesartan (Atacand®)
Irbesartan (Avapro®)
Losartan (Cozaar®)
Olmesartan (Olmetec®)
Telmisartan (Micardis®)
Valsartan (Diovan®)
  • Relaxes blood vessels & lowers blood pressure
  • Decreases the risk of future heart attacks
  • Alternative to ACE inhibitors
  • Dizziness, lightheadedness
  • Headache
  • Increased potassium level in blood
Calcium Channel Blockers Amlodipine (Norvasc®)
Felodipine (Plendil®, Renedil®)
Nifedipine (Adalat XL®)
Diltiazem (Cardizem CD®, Tiazac®)
Verapamil (Isoptin®)
  • Lowers blood pressure
  • Lowers heart rate (diltiazem, verapamil)
  • Helps prevent angina
  • Slows irregular heart rhythms (diltiazem, verapamil)
  • Dizziness, lightheadedness
  • Fatigue/tiredness
  • Headache
  • Swelling of ankles/feet
Diuretics (Water Pills) Ethacrynic Acid (Edecrin®)
Furosemide (Lasix®)
Hydrochlorothiazide (HCTZ, HydroDiuril®)
Metolazone (Zaroxolyn®)
  • Removes excess water by increasing urine production
  • Reduces swelling in legs and ankles
  • Dizziness/lightheadedness
  • Decreased potassium level in blood
  • Gout
Potassium Supplement Potassium Chloride (Slow K®, K-Dur®)
  • Replaces potassium in blood
  • Nausea/vomiting
Anticoagulants Apixaban
Dabigatran (Pradax®)
Rivaroxaban (Xarelto®)
Warfarin (Coumadin®)
  • Helps prevent blood clots from forming or getting bigger
  • Increased risk of bleeding and bruising
Anti-arrhythmics Amiodarone (Cordarone®)
  • Makes the heart beat more regularly
  • Nausea/vomiting
  • Skin may burn more easily under the sun
  • Sun exposed skin may turn bluish grey
  • Thyroid abnormality
  • Decrease in liver function
  • Lung damage (rare)
Dronedarone (Multaq®)   
  • Nausea/vomiting
  • Diarrhea
Sotalol (Sotacor®)  
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing
Digitalis Digoxin (Lanoxin®, Toloxin®)
  • Slows down irregular heart rhythms
  • Strengthens the heart’s pumping
  • Nausea/vomiting – Notify doctor if persistent

 

Manage Your Medications Safely

When you are discharged, you will receive a prescription for your new medications.

1. Make sure your doctor knows all the medications and supplements that you were taking previously so you can both feel confident that you are getting the right prescription.

2. When you receive the prescription, make sure you ask:

  • The name of the medication
  • Why it is being prescribed
  • When and how should it be taken
  • How long you will need to take it
  • What side effects you should expect to have
  • What you should do about the side effects

3. When you pick up your prescription, ask your pharmacist:

  • To explain the best way to take the medication
  • To explain what is written on the labels
  • To provide written information about the medication

4. Try to use the same pharmacy for all your prescriptions. It is important for your pharmacist to have a complete list of all your medications. Your pharmacist can then evaluate if all your medications can be safely taken together.

5. Carry your medication list with you. Make sure the list includes:

  • All your medications, as well as any vitamins, supplements and herbals
  • Your allergies, immunizations and pharmacy phone number

6. Review the list regularly with your doctor or pharmacist.

7. If you have trouble remembering to take your medications, the following tips are “tried and true”:

  • Take your medications at the same time each day.
  • Associate your medications with daily activities like:
    • Brushing your teeth or
    • Mealtimes or
    • Bedtime
  • Use a pill organizer (dosette) with different compartments for different times of the day.
  • Ask your pharmacy if they can organize your pills in blister packs.
  • Keep a one-day supply of your medications in your handbag or at the office.
  • If your medications are complicated, ask your doctor if something simpler can be prescribed.
  • Put a note on your calendar to remind you to pick up your prescription refills.

8. Do not store your medication in hot or humid areas, such as the bathroom or glove compartment of your car. These conditions will shorten the expiry of your drugs.

9. Take the medication as it is prescribed by your doctor. If you have concerns about taking medications, discuss them openly and honestly with your doctor. If you experience troublesome side effects, your doctor may be able to prescribe a different kind of medication.

10. If you are worried about the cost of your medication, ask your doctor if a less expensive medication can be substituted, or check with the Ontario Trillium Program for possible assistance:

  • Phone: 1-800-575-5386

In Case of an Emergency

Before you are discharged from the hospital, your nurse will supply you with your Vial of Life kit. If you are ever in need of emergency medical help, the Vial of Life is a quick way for paramedics and hospital staff to know what medications you are taking, your emergency contacts, and any pertinent health information.

When preparing your Vial of Life:

  1. Print clearly.
  2. Complete your Vial of Life Medication Sheet.
  3. Complete your Vial of Life Information Sheet.
  4. Place both forms in your vial and store it in the freezer door of your refrigerator.
  5. Place the Vial of Life magnet on the top right corner of your refrigerator.
  6. Remember to update your medication list every time your prescription changes.

What to do if your angina or heart pain occurs:

If you experience angina discomfort/pain please do the following:

At the first sign of discomfort > Stop immediately and rest
If no relief with rest > Take 1st nitroglycerin spray/tablet
If no relief within five minutes > Take 2nd nitroglycerin spray/tablet
If no relief within five minutes > Take 3rd nitroglycerin spray/tablet

 

 

 

 

If no relief after the 2nd nitroglycerin spray/tablet, call 911 or have someone else drive you to the nearest emergency department.

It is important to let your cardiologist and family doctor know if you experience any changes in your symptoms.