Common Heart Medications: What to Know

If you recently have been diagnosed with a heart disease or experienced a heart attack, you may have been prescribed some medications to treat symptoms, such as hypertension, blood clotting, arrhythmia, chest pain, high cholesterol, and more. It’s important to understand why you have been prescribed certain medications and how those medications work.

Anticoagulants

Anticoagulants are medications used to prevent the forming of blood clots in the bloodstream and may prevent clots from becoming larger. While anticoagulants are commonly referred to as “blood thinners”, these medications do not thin the blood, nor do they completely stop blood from clotting. Patients taking anticoagulant medication may experience wounds that take longer to stop bleeding due to the medication’s anticoagulating effects.¹

Commonly Prescribed Blood Thinners²

• Apixaban (Eliquis) 

• Dabigatran (Pradaxa)

• Edoxaban (Savaysa)

• Heparin

• Rivaroxaban (Xarelto)

• Warfarin (Coumadin)

Antiplatelets are a group of anticoagulants that work to prevent blood platelets from sticking together and forming a blood clot. Antiplatelets are more suitable for patients who have experienced a heart attack or stroke due to narrowing of blood vessels.¹

Commonly Prescribed Antiplatelet Agents²

• Aspirin

• Clopidogrel (Plavix)

• Dipyridamole (Persantine)

• Prasugrel (Effient)

• Ticagrelor (Brilinta)

ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors are medications that help relax the veins and arteries by widening blood vessels to lower blood pressure, reducing the workload of the heart. ACE inhibitors are commonly used to prevent, treat, or improve symptoms in conditions such as: hypertension, coronary artery disease, heart failure, diabetes, chronic kidney disease, heart attacks, and more. ³

Commonly Prescribed ACE Inhibitors²

• Benazepril (Lotensin)

• Captopril (Capoten)

• Enalapril (Vasotec)

• Fosinopril (Monopril)

• Lisinopril (Prinivil, Zestril)

• Moexipril (Univasc)

• Perindopril (Aceon)

• Quinapril (Accupril)

• Ramipril (Altace)

• Trandolapril (Mavik) 

Angiotensin II receptor blockers

Used to treat high blood pressure, angiotensin II receptor blockers, or ARBs, block the chemical angiotensin II from narrowing blood vessels. As a result, the medication relaxes and widens blood vessels to lower blood pressure. ARBs are commonly used to prevent, treat, or improve symptoms in patients with chronic kidney disease, heart failure, and kidney failure.⁴

Commonly Prescribed ARBs²

• Azilsartan (Edarbi)

• Candesartan (Atacand)

• Eprosartan (Teveten)

• Irbesartan (Avapro)

• Losartan (Cozaar)

• Olmesartan (Benicar)

• Telmisartan (Micardis)

• Valsartan (Diovan)

Beta blockers

Beta blockers are medications used to treat high blood pressure by blocking the effects of epinephrine. This slows heart rate and causes the heart to beat with less force. This helps lower blood pressure and improves blood flow by widening veins and arteries. Beta blockers are commonly used to treat high blood pressure when other medications have not worked and are used to prevent, treat, or improve symptoms in conditions, such as: arrhythmia, heart failure, chest pain, heart attacks, and more.⁵

Commonly Prescribed Beta Blockers²

• Acebutolol (Sectral)

• Atenolol (Tenormin)

• Betaxolol (Kerlone)

• Bisoprolol/hydrochlorothiazide (Ziac)

• Bisoprolol (Zebeta)

• Metoprolol (Lopressor, Toprol XL)

• Nadolol (Corgard)

• Propranolol (Inderal)

• Sotalol (Betapace)

Calcium channel blockers

Calcium causes the heart and arteries to squeeze strongly. To lower blood pressure, calcium channel blockers stop calcium from entering the cells of the heart and arteries, allowing blood vessels to relax and widen. Calcium channel blockers can also slow heart rate, further lowering blood pressure. In addition to treating high blood pressure, calcium channel blockers are commonly used to prevent, treat, or improve symptoms in patients with coronary artery disease, chest pain, arrhythmia, and blood vessel conditions.⁶

Commonly Prescribed Calcium Blockers²

• Amlodipine (Norvasc)

• Diltiazem (Cardizem, Tiazac)

• Felodipine (Plendil)

• Nifedipine (Adalat, Procardia)

• Nimodipine (Nimotop)

• Nisoldipine (Sular)

• Verapamil (Calan, Verelan)

Cholesterol-lowering medications

Cholesterol is a waxy, fatlike substance found in your blood. Low-density lipoprotein (LDL) or “bad” cholesterol can lead to fatty buildups in your arteries, increasing the risk for heart disease, heart attacks, or strokes. To decrease “bad cholesterol” and increase high density lipoprotein (HDL) or “good cholesterol”, your healthcare provider may prescribe a cholesterol-lowering medication.

Commonly Prescribed Cholesterol-Lowering Medications

Statins²

Satins are prescribed to decrease “bad cholesterol” and triglycerides, a type of fat in the blood that increases the risk of heart disease. Statins may also increase “good cholesterol.”⁷ Commonly prescribed statins include:

• Atorvastatin (Lipitor)

• Fluvastatin (Lescol)

• Lovastatin (Mevacor)

• Pitavastatin (Livalo)

• Pravastatin (Pravachol)

• Rosuvastatin (Crestor)

• Simvastatin (Zocor)

Nicotinic Acids²

Niacin is prescribed to decrease “bad cholesterol” and triglycerides, while also increasing “good cholesterol.”⁷

Cholesterol Absorption Inhibitors²

Cholesterol absorption inhibitors, such as ezetimibe (Zetia), are prescribed to decrease “bad cholesterol” and slightly decrease triglycerides. Cholesterol absorption inhibitors may also increase “good cholesterol.”⁷

Combination Statin and Cholesterol Absorption Inhibitors²

Combination statin and cholesterol absorption inhibitors, such as ezetimibe/simvastatin (Vytorin), are prescribed to decrease “bad cholesterol” and triglycerides, while also increasing “good cholesterol.”⁷

Drug and Supplement Interactions

Many herbal supplements may interact with medications used to treat heart and blood vessel conditions. Below are some common herbal supplement and drug interactions:⁸

• COQ-10 may lessen how well warfarin works and further lower blood pressure if you also take a medication to treat high blood pressure.⁸

• Danshen may interact with blood thinners, blood pressure medications, and digoxin (Lanoxin).⁸

• Evening primrose, garlic, ginkgo biloba may increase your risk of bleeding if you take blood thinners, such as aspirin, clopidogrel, and warfarin.⁸

• Ginseng may lessen how well warfarin works.⁸

• Hawthorn may interact with beta blockers, calcium channel blockers, nitrates, and digoxin.⁸

If you are taking a prescription, heart-related or not, it is recommended to consult with your healthcare team (including our pharmacy team!) before making any major change in diet or supplementation. Your healthcare team can evaluate what may best fit your needs, check for interactions, and more.

If you have any questions about your medication regimen, it is encouraged to consult your healthcare team, including your pharmacist. As your pharmacy, we are dedicated to providing you with the best possible care, beyond just dispensing medications. We are here to address your questions and concerns and support your unique healthcare needs.

Sources

1.      https://www.ncbi.nlm.nih.gov/books/NBK279433/

2.      https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications 

3.      https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/ace-inhibitors/art-20047480

4.      https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/angiotensin-ii-receptor-blockers/art-20045009#:~:text=Angiotensin%202%20receptor%20blockers%20stop,Valsartan%20(Diovan).

5.      https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522

6.      https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/calcium-channel-blockers/art-20047605

7.      https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-medications/art-20050958

8.      https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/herbal-supplements/art-20046488