Common Medications May Worsen Heart Failure Symptoms

Common drugs such as metformin or anesthesia could potentially cause complications for patients with heart failure.

The American Heart Association (AHA) recently released a warning that some heart failure cases can be worsened by drugs to treat other conditions and even supplements.

Patients with heart failure also typically have 5 or more medical conditions, and take 7 or more prescription medications daily, according to the statement.

“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,” said author Robert L. Page II, PharmD, MSPH.

Even over-the-counter medications, such as non-steroidal anti-inflammatory drugs, can worsen heart failure by causing fluid retention and making diuretic medications ineffective. Categories of medications such as anesthesia, antidiabetics, antiarrhythmics, antihypertensives, anti-infectives, anticancer, hematologic, and other drugs could be dangerous for heart failure patients, according to the AHA.

“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.

Natural supplements such as St. John’s wort, ginseng, hawthorn, danshen, and green tea could interfere with common heart failure treatments. The AHA also states that natural alternatives should not be substituted for heart failure medications.

It is likely that patients are being prescribed medications by different clinicians who likely do not consider possible drug-drug interactions, which could lead to adverse effects for patients. These medications could potentially be toxic to heart muscles, change how the heart contracts, loss of beneficial outcomes, and some contain levels of sodium higher than advised.

“My hope is that this statement will be used by healthcare providers in all medical specialties to educate themselves about drugs that can exacerbate or cause heart failure,” Page concluded.