AHA statement identifies drugs to avoid in patients with heart failure
The American Heart Association has published a scientific statement providing prescribers with a list of drugs that can cause or worsen heart failure.
Heart failure patients are usually taking medications for multiple medical conditions with resulting risk for drug-drug or drug-condition interactions.
Chair of the writing committee, Robert Page said, “Since many of the drugs heart failure patients are taking are prescribed for conditions such as cancer, neurological conditions, or infections, it is crucial but difficult for healthcare providers to reconcile whether a medication is interacting with heart failure drugs or making heart failure worse.”
In addition to prescription medications, over the counter drugs may also have unintended consequences for heart failure patients. For example, non-steroidal anti-inflammatory drugs (NSAIDs), including commonly used painkillers such as ibuprofen, can trigger or worsen heart failure by causing sodium and fluid retention and making diuretic medications less effective.
Over-the counter heartburn medications and cold remedies may also contain significant amounts of sodium, which is usually restricted in patients with heart failure. In addition, many supplements used in complementary and alternative medicine can be dangerous for people with heart failure, including products containing ephedra (which raises blood pressure) and others (including St. John’s Wort, ginseng, hawthorn, danshen, and green tea) that interfere with one or more commonly used heart failure medications.
Note: Some of these medications may not be available in the UK.
AHA Scientific Statement. Drugs that may cause or exacerbate heart failure. Circulation 2016, published 9 August, doi: http://dx.doi.org/10.1161/CIR.0000000000000426
Supporting information on the AHA website
NICE guideline (CG108). Chronic heart failure in adults: management.