Heart Failure Medicines Pharmacology Guide

Most people with heart failure are treated with medication. Often you’ll need to take 2 or 3 different medicines.
‘Heart failure’ does not mean that your heart is about to stop. But if it is not working well, it will not be able to meet all your body’s needs. Many people with heart failure get short of breath, tired, and get fluid build up in their ankles, legs, chest and stomach.

Heart failure is sometimes called ‘congestive heart failure’ (CHF), ‘cardiac impairment’ or ‘chronic heart failure’.
Managing heart failure includes checking weight and making lifestyle changes, and taking regular medicines. Most people need to take ACE inhibitors and beta blockers, and sometimes spironolactone. Here you will get information about these medicines and others that are commonly used to treat heart failure.

Some of the main medicines for heart failure include:
ACE inhibitors
angiotensin receptor blockers (ARBs)
beta blockers
mineralocorticoid receptor antagonists
sacubitril valsartan
hydralazine with nitrate

ACE inhibitors:

ACE inhibitors relax blood vessels to make it easier for the heart to pump blood around the body. ACE inhibitors will improve your symptoms and improve your survival. ACE inhibitors also lower blood pressure, and this can limit the dose that you can tolerate before you become light-headed.

Angiotensin Receptor Blockers:

ARBs (candesartan and losartan) have the same effect as ACE inhibitors but work in a slightly different way.

Some ARBs have a diuretic medicine (to remove excess water) added to them inthe same tablet. These include Hypocart®and Hyzaar.

What are some of the side effects?

Some people may get:
• A headache
• Nausea or vomiting
• Dizziness or faintness
• A rash (rare)
• A change in their taste (rare)

Tell your doctor if any of these things happen to you. Sometimes these side effects happen straight away, sometimes they happen months later. If you are taking an ACE inhibitor and get a dry cough, let your doctor know, you may be changed to an ARB (candesartan or losartan).
Some side effects can be serious but are rare. Phone your doctor straight away if your lips, throat or tongue swell up.

Beta blockers:

Beta blockers are medicines that block adrenaline from damaging the heart pump and causing electrical disturbance (‘cardiac arrest’). They also lower blood pressure and slow the heart rate. They help to improve heart function, and improve your survival.

What are some of the side effects?

When you first start a beta blocker or have your dose increased, you may feel tired or have other side effects for a few days. These side effects usually go away. Tell your doctor if you get any of these feelings or if they do not go away:
Cold hands and feet
Dizziness or tiredness
Nightmares or sleep problems
Constipation or diarrhoea
Rash or itching


Spironolactone (Spiractin® Spirotone®) helps to reduce symptoms and improve survival in patients who have heart failure because of weak heart muscle. Spironolactone has a weak diuretic effect, so will also help to rid your body of extra fluid.

What are some of the side effects?

Upset stomach or diarrhoea
Leg cramps at night
In men – breast tenderness and/or enlargement


Diuretics (water pills) make you pass more urine and help relieve ankle swelling and breathlessness caused by heart failure. There are many different types of diuretic, but the most widely used for heart failure are furosemide (also called frusemide) and bumetanide.

What are some of the side effects?

Tell your doctor if you have any of the following problems:
Extreme thirst
Dark coloured urine
You may need to have a smaller dose Also
• If you have diabetes, diuretics raise your blood sugar levels
• Diuretics may cause gout or make it worse
• Your doctor will check your potassium levels because diuretics can cause your body to lose potassium


Digoxin (Lanoxin®) is mainly used for people who have an irregular heart beat called atrial fibrillation (AF). Possible side effects include dizziness, blurred vision, feeling and being sick, diarrhoea and an irregular heartbeat.


Amiodarone (Aratac® Cordarone X®) may be used to control an irregular heart beat, before you start taking other heart failure medicines.

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