For heart failure patients, missing your treatment too often can put you at higher risk of cardiovascular complications.
Because EVERY PILL MATTERS, follow your prescription.
What is the purpose of my treatment?
Heart failure is a serious condition that can be managed very effectively with medical care and medications.
Each prescribed medication helps the heart in a different way. For example, there are treatments to slow the heart rate, reduce blood pressure, remove excess fluid… While these medicines do not cure heart failure, they all improve your symptoms and quality of life, as well as increase survival and allow you to stay out of hospital.1
There are 4 main classes of recommended drugs at the optimal dosage:2
Your treatment will also be personalized with additional medication, to better manage your condition:3
Optimal dosage
It is the best level of medicine that can control symptoms with minimum likelihood of undesirable symptoms. It is not the maximal dose. Each patient is unique, each optimal dose is too.2
This might sound like a lot of medications, but when your heart failure is managed well with individualized treatment, you have the best chance of leading a full and normal life.
Can I stop taking my medication?
No. Feeling better is a good sign as it means the medications are doing their job, but while your symptoms may have improved it does not mean the problem has gone away.
To continue feeling well, prevent your condition deteriorating, and live longer, it is important to keep taking all your medications at the doses your doctor prescribed and to follow diet and exercise recommendations.4,5
A dose might be adjusted or a medication changed, but this should always be in consultation with your doctor.
What should I do if I forget to take my medication?
If you forget to take a dose of your medication, check the information leaflet that came with the medication for advice, or contact your doctor or pharmacist. Usually, you should take it as soon as you remember, unless it is less than 6 hours before your next dose. In this case, just leave out the missed dose and take your next dose as normal. Once-daily drugs can be taken a little later during the day.6
Never take 2 doses at the same time, and never take an extra dose to make up for a forgotten dose. Taking 2 tablets close together or at the same time can increase the amount of drug in your body, which may cause side effects.
When you are sick, it is easy to become dehydrated from vomiting, diarrhea, and/or a fever. Try to maintain your fluid levels and to keep your normal medication schedule.
Vomiting can effectively mean a missed dose and a general rule is that if you vomit within 15 minutes of taking your medication, you should take it again. However, this may vary depending on your individual medications and it is best to ask your doctor or pharmacist for advice.
What about possible disruptions to therapy?
Try to organize your day in advance. For example, if you will be attending a meeting it may be advisable not to take a diuretic immediately before, but schedule for later in the day when you have free time.
Most people associate taking their medication with a daily routine, which is likely to be disrupted when traveling. This will be further complicated if you are traveling to a different time zone. If your destination time zone is more than 3 hours different, adjust your medicines to your new time zone. Flying is not normally a problem, but it can cause you to become dehydrated so remember to drink plenty of water.7
When you travel, always carry extra medication with you in case you are delayed. This is particularly important when going abroad as it can be difficult to obtain prescription drugs in a different country and other brands may have varying strengths.7
Always pack your medication in your hand luggage in case your suitcase is delayed or lost. You should also carry a copy of your prescription and a letter from your doctor explaining your condition, in case you need to answer any questions at security.
How can I remember to take my medication?
To make it easier to remember to take your heart failure medication, try these simple tips:8
- Set up reminders: Use an app or the alarm or calendar function on your phone to set up reminders.
- Create a routine at the same time as an activity you do every day, eg, brushing your teeth.
- Keep it visible to avoid “out of sight, out of mind”, leave your medication in a safe place that is easy to spot.
- Use a pillbox with compartments for each day and dosing time which can be pre-filled once a week with all your medications. This immediately allows you to see if you have taken your medication and also prevents you from taking a double dose.
- Single-pill combinations exist for some of your treatments. Talk to your doctor, you may find a way to reduce the number of pills.
Most medicines have unwanted effects, including those for heart failure. What is important to remember is that this is normal, and that everyone reacts differently.
Some side effects are temporary and disappear after your body has adjusted to the new treatment, so give your medication time to work as sometimes it is difficult to tell the difference between symptom and side effect.
If you are experiencing side effects, it is very important not to stop without letting your doctor or pharmacist know. They may be able to adjust the dosage or prescribe an alternative to improve the side effects you’re experiencing.
Common side effects of heart failure treatment that you may want to know:
What about foods or supplements interacting with treatment?
Some food and dietary supplements may need to be avoided as they can interact with your medications and cause too much or too little of a drug to stay in the body. Too much drug increases the risk of side effects, while too little means the drug may not work as well.12
- It is necessary to avoid consuming grapefruit juice with certain prescription medications, especially around the time you take the medication.
- Too much salt can increase the amount of fluid retained in your body, making your medication dose inadequate.
- Several supplements used in complementary and alternative medicine may also need to be avoided. Products containing ephedra can increase heart rate and raise blood pressure.
- Other supplements that can interfere with one or more commonly used heart failure medications include ginseng, hawthorn and green tea.12
Talk to your doctor
What about self-medication?
When you have heart failure you may need to avoid a number of common over-the-counter medications, either because they can make your heart failure symptoms worse or because they interact with your prescription heart failure medications.12
For example, if you have a cold or the flu you should not take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and effervescent drugs as they contain sodium, which can cause you to retain fluid and make your heart failure worse.12
Many over-the-counter cold medicines, including nasal sprays, also contain decongestants such as phenylephrine, pseudoephedrine, oxymetazoline, and naphazoline, which can raise blood pressure and interfere with prescription medicines.12
Some laxatives and antacids for relief of indigestion or heartburn contain high levels of sodium, which can increase water retention.12
Both laxatives and antacids may also interfere with other drugs and should not be taken at the same time as prescription medicines.
Is useful to make a list of all your medications and keep a copy with you. Before you take any over-the-counter medicine, ask your doctor or pharmacist if it is safe to take it with your heart failure and other prescription medicines.
If you have any doubts or questions, do not hesitate to contact your pharmacist or doctor.
