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Congestive heart failure medications overview
Congestive heart failure is a chronic (ongoing) condition. Discuss all medications, herbs, supplements you are taking with your doctor. Listed are some of the medications used to treat congestive heart failure.
ACE inhibitors (angiotensin converting enzyme)
ACE inhibitors have been used for the treatment of hypertension for more than 20 years. This class of drugs has also been extensively studied in the treatment of congestive heart failure. These medications block the formation of angiotensin II, a hormone with many potentially adverse effects on the heart and circulation in patients with heart failure. In multiple studies of thousands of patients, these drugs have demonstrated a remarkable improvement of symptoms in patients, prevention of clinical deterioration, and prolongation of survival. In addition, they have been recently been shown to prevent the development of heart failure and heart attacks. The wealth of the evidence supporting the use of these agents in heart failure is so strong that ACE inhibitors should be considered in all patients with heart failure, especially those with heart muscle weakness.
Possible side effects of these drugs include:
- a nagging, dry cough,
- low blood pressure,
- worsening kidney function and electrolyte imbalances, and
- rarely, true allergic reactions.
When used carefully with proper monitoring, however, the majority of individuals with congestive heart failure tolerate these medications without significant problems. Examples of ACE inhibitors include:
- captopril (Capoten),
- enalapril (Vasotec),
- lisinopril (Zestril, Prinivil),
- benazepril (Lotensin), and
- ramipril (Altace).
For those individuals who are unable to tolerate the ACE inhibitors, an alternative group of drugs, called the angiotensin receptor blockers (ARBs), may be used. These drugs act on the same hormonal pathway as the ACE inhibitors, but instead block the action of angiotensin II at its receptor site directly. A small, early study of one of these agents suggested a greater survival benefit in elderly congestive heart failure patients as compared to an ACE inhibitor. However, a larger, follow-up study failed to demonstrate the superiority of the ARBs over the ACE inhibitors. Further studies are underway to explore the use of these agents in congestive heart failure both alone and in combination with the ACE inhibitors.
Possible side effects of these drugs are similar to those associated with the ACE inhibitors, although the dry cough is much less common. Examples of this class of medications include:
- losartan (Cozaar),
- candesartan (Atacand),
- telmisartan (Micardis),
- valsartan (Diovan),
- irbesartan (Avapro), and
- olmesartan (Benicar).
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Need help identifying pills and medications?
Use the pill identifier tool on RxList.