Medicines and Products for Heart Failure

Medicines are the backbone of heart failure treatment. Many improve survival and reduce hospital stays. They should be taken as prescribed and never stopped without your cardiologist's advice.

Common medicines

• ACE inhibitors, ARBs or ARNI (sacubitril-valsartan): relax blood vessels and protect the heart.
• Beta blockers (such as carvedilol, metoprolol succinate and bisoprolol): slow the heart and improve pumping over time.
• Mineralocorticoid receptor antagonists (spironolactone, eplerenone): reduce fluid and protect the heart.
• SGLT2 inhibitors (dapagliflozin, empagliflozin): now a core treatment for many types of heart failure, with or without diabetes.
• Diuretics (furosemide, torsemide): remove extra fluid and relieve breathlessness and swelling.
• Others: ivabradine, digoxin, hydralazine with nitrates, and iron treatment in selected patients.
• Devices: implantable defibrillators and cardiac resynchronisation for selected patients.

Safety points

• Do not stop or change doses on your own, even if you feel well.
• Report dizziness, fainting, very low urine, muscle weakness, swelling of face or lips, or persistent cough.
• Blood tests for kidney function and potassium are needed regularly.
• Avoid NSAID painkillers, and check with your doctor before any new medicine or supplement.
• Herbal products can interact with heart failure drugs. Do not use them in place of prescribed medicines.

When to seek help

Call 112 or 102 for severe breathlessness, chest pain, fainting or swelling of the throat.

Key point

Regular medicines and follow-up visits are the most effective way to stay well.

Before your appointment

Bring your list of medicines and supplements, recent test reports such as echocardiogram, ECG and kidney tests, and your daily weight and blood pressure log. Note any breathlessness, swelling, night-time symptoms or reduced activity, and how much salt and fluid you take. Ask about warning signs and when to call 112 or 102.