Heart failure

Warfarin, digoxin, asprin and statins

In addition to the triple combination of diuretics, ACE inhibitors and beta-blockers (see 'Beta-blockers, ACE inhibitors, diuretics and aldosterone antagonists') several drugs are commonly prescribed to help relieve symptoms of heart failure. Among people we talked to these included daily aspirin; a cholesterol-lowering drug (statin); warfarin (which prevents blood clots forming); digoxin (which can control heart rhythm and slightly increases the force of the heartbeat). Most people said that their drugs had to be carefully balanced. A woman who had been taking warfarin and digoxin for 44 years, said that coping with the 'whole rigmarole' of drugs had become second nature to her.

Aspirin reduces the ability of blood clots to form thereby reducing the risk of having a heart attack. Sometimes people are given a drug called clopidogrel instead of or as well as aspirin. This combination treatment is usually given for a limited time but Tim says he was put back on it for life after having another heart attack after stopping clopidogrel.

Several people who had had heart failure for many years talked about how drugs had changed; one said that was the only advance that he had noticed in the treatment of heart failure. Warfarin was widely thought of as an 'older' drug that thinned the blood, and was known to have the same active ingredient as rat poison. People recognised that warfarin needed to be carefully monitored and that it could cause bleeding; two people had bled into their urine as a result of taking warfarin. One woman said that she was careful to check whether warfarin would be affected by other medicines such as antibiotics. She also found that the herbal remedy valerian interfered with warfarin. It is not unusual for herbal remedies to interact with prescribed medicines, so people should always talk to their doctor if they are considering taking them.

People on warfarin who need surgery have their warfarin treatment stopped and replaced by heparin until after the procedure to avoid the danger of excessive bleeding. After surgery people are put back on warfarin under careful monitoring.  
Many of those who took digoxin knew it was derived from foxgloves and that it slowed the heartbeat. One woman referred to digoxin as a poison that did her good. Some people said they decided not to take it, against doctors advice. Others said that they were taking a lower dose now than they used to.

Simvastatin - a medicine that reduces cholesterol in the blood - was mentioned by many people and several wondered whether they would have avoided heart failure if it had been prescribed at an earlier stage. A man who couldn't tolerate simvastatin said that another medicisne (cholestyramine) was able to reduce some of the kinds of fat in body (see 'Other side effects of heart failure medication').

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See our resources for publications which explain heart failure medications in more detail.

 

Last reviewed April 2016.
Last updated April 2016.

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