There are many different medicines that are prescribed within the treatment of heart disease. You may have to take several different medicines every day. Though this can sometimes be difficult to deal with, try to remember your doctor is aiming to keep you as well as possible and will try to find the best medicines for you with the fewest side effects.
If prescribed medicines:
- always take your medicines as prescribed by your doctor
- report any side effects but don’t stop taking any medicines suddenly or without your doctor’s advice
- discuss all over-the-counter remedies with your pharmacist to make sure they won’t interact with any prescribed medicines you’re taking. You should always tell the pharmacist and doctor/ health professional about any additional medications you’re taking
- never take or "borrow" any medications prescribed for someone else
- remember drugs are often given in various combinations and are tailored to individuals. Every person may have different combinations and doses of these medications, and these may require increase or decrease in time
- any side effects or change in symptoms after you start taking a medication should be discussed with the person who prescribed them or your GP or pharmacist
- some people sometimes forget to take their medicines. If you need help remembering to take them, talk to your doctor, pharmacist or nurse
Different types of medicines
There are lots of different medicines used to treat diseases of the heart, but they all belong to a few main groups, including:
- ACE inhibitors like ramipril
- angiotensin-II antagonists like losartan
- anti-arrhythmic medicines like amiodarone
- anticoagulant medicines like warfarin
- anti-platelet medicines like aspirin
- beta-blockers like bisoprolol
- calcium-channel blockers like amlodipine
- cholesterol-lowering medicines like simvastatin and other statins
- diuretics (water pills) like bendroflumethiazide
- nitrates like glyceryl trinitrate (GTN) tablets or spray [link]
The medicines within each group are similar, but may have minor variations in how they work.
Occasionally, two medicines may be combined into one tablet.
All this means that there is a wide variety of medicines to choose from to best meet your individual needs. Sometimes, the same medicine can even be used to treat a number of different conditions.
A single medicine may have several different names. Each one has an official name, called the ‘generic’ or ‘non-proprietary’ name. It may also be prescribed under one or more brand names, or ‘proprietary names’.
What conditions are medicines used for?
- angina - pain or discomfort in the chest, or shortness of breath
- heart attack - when there is a blockage in a coronary artery
- high blood pressure - also called hypertension
- heart failure - when the main pumping action of the heart is not working as well as it should be
- arrhythmia - a heart rhythm that may be too slow, too fast or irregular. See Chest Heart & Stroke Scotland for more on arrhythmias.
- heart valve disease - when one or more of the four valves in the heart is diseased or damaged. See Chest Heart & Stroke Scotland for more on heart valve problems.
- high blood cholesterol level - also called hypercholesterolaemia, which, if left untreated, increases the risk of having a heart condition.
How are medicines taken?
- by mouth (orally) - most medicines for the heart are taken by mouth, usually as tablets, capsules or liquids, which you swallow or take dissolved in water
- under your tongue (sublingually) - you put a tablet under your tongue and allow it to dissolve, or you spray the medicine directly under your tongue
- into a veing (intravenously) - injected directly into a vein, or given in a diluted form through an intravenous drip
- into a muscle (intramuscularly) - given by an injection into a muscle, like the buttock or thigh
- under the skin (subcutaneously) - given by an injection just under the skin
- self-adhesive patch - you put a patch containing the medicine on your skin, and the medicine is absorbed gradually
Most medicines need to be taken regularly, as prescribed by your doctor. Some medicines need to be taken only when you get a particular symptom, like angina.
Like most people, you’ll probably not experience any side effects at all. Even if you do, they can sometimes disappear after a while.
For more information about possible side effects of your medicines, read the information leaflet that comes with the medicine. If you’re worried about side effects, speak to your GP or pharmacist.
If you develop any new, persistent or troublesome symptoms after starting a medicine, tell your doctor about them immediately.
They may be able to reduce the dose or prescribe a different medicine.
Don’t stop taking your prescribed medicines without medical advice, because this could make your condition worse.
Some medicines contain sodium, which is found in salt. Having a large amount of salt in your diet increases the risk of having high blood pressure and cardiovascular disease. Check the information sheets that come with your medicine. If you’re worried, ask your GP or pharmacist.
Grapefruit and grapefruit juice can affect the way a number of medicines for heart conditions work. For example, they can increase the effect of the medicine, which can make you feel unwell. If you’re worried about whether it’s safe for you to have grapefruit or grapefruit juice, ask your GP or pharmacist.
Pregnancy and breastfeeding
There are some medicines pregnant or breastfeeding women shouldn’t take. If you need to take medicines for a heart condition, your doctor will consider the risks to both you and your baby very carefully.
Usually, medicines should only be prescribed in pregnancy if the expected benefit to the mother is thought to be greater than the risk to the baby. You should avoid taking any medicines during the first three months of pregnancy if possible. If you do need to take medicines, you’ll be given the safest one available.
Many medicines have side effects that are potentially harmful during pregnancy. Talk to your GP or midwife before taking any medicines - even ones you can buy over the counter without a prescription.