Many drugs can cause or worsen heart failure, cautions new statement

http://www.eurekalert.org/pub_releases/2016-07/aha-mdc070616.php

Public Release: 11-Jul-2016
Many drugs can cause or worsen heart failure, cautions new statement
American Heart Association Scientific Statement
American Heart Association

Commonly used medications and nutritional supplements may cause or worsen heart failure, according to the first scientific statement from the American Heart Association to provide guidance on avoiding drug-drug or drug-condition interactions for people with heart failure.

The statement provides comprehensive information about specific drugs and "natural" remedies that may have serious unintended consequences for heart failure patients.

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"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,"

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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.

"Patients have been taught to read food labels for sodium content, but they also need to read labels on over-the-counter medications and natural supplements," Page said.

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. The statement also notes that nutritional supplements, herbs and other "natural" remedies should not be used to treat or manage heart failure symptoms.

"Keep a list of all your medications and doses to show at every medical visit, and inform a healthcare provider treating your heart failure before stopping or starting any medication. Ideally there should be a "captain" who oversees your medications. This person might be a physician, advanced practice nurse, nurse or a pharmacist who is managing your heart failure," Page said.

According to the statement, medications can cause problems in several ways: being toxic to heart muscle cells or changing how the heart muscle contracts; interacting with medications used to treat heart failure so that some of their benefits are lost; and containing more sodium than advised for patients with heart failure.