Heart Failure: Avoiding Medicines That Make Symptoms Worse


If you have heart failure, you need to be extra careful with medicines. Some can make your heart failure worse. Other medicines may not mix well with your heart failure drugs.

This Actionset will help you learn which medicines you may need to avoid and what questions to ask your doctor or pharmacist.

  • Each time you see a doctor, make sure he or she knows that you take medicines for heart failure.
  • Before you fill any new prescription, tell the pharmacist that you have heart failure. Ask if it's okay to take the new prescription medicine.
  • Before you take any over-the-counter medicine, such as a cold or flu remedy, ask your doctor or a pharmacist if it is safe to take it with your heart failure medicines.
  • Tell each doctor about all the other medicines you take. This includes over-the-counter medicines, such as cold and flu remedies, herbal products, and natural supplements and vitamins. Take a list of your medicines or bring your medicines to each doctor's appointment.
  • Whether or not some medicines will make your heart failure worse depends on how severe your heart failure is. It also depends on what type of heart failure you have.

How do you know if your other medicines are safe to take with your heart failure medicines?

Talk to your doctor or a pharmacist. Show him or her a list of all the medicines you take.

Be organized

It's important to keep an up-to-date list of your medicines. Here are some tips:

  • Make a list of everything you take. Keep a copy in your purse or wallet, and take it to each doctor or hospital visit. Anytime you see a new doctor, show him or her your list.
  • Remember to include herbs, vitamins, and over-the-counter medicines on your list.
  • Have each doctor keep a copy of your list of medicines in your file.
  • Make sure your spouse, a family member, your caregiver, or a friend has an extra copy of your list of medicines.
  • Use the same pharmacy or drugstore for all of your prescriptions.
  • Update your list if you start a new medicine or stop taking one.

Ask questions

What if you need to take a medicine that can make heart failure worse? Here are some things you can do:

  • Ask your doctor or a pharmacist if it is safe to take the medicine.
    • For example, if you have a cold or the flu, ask which medicine is safe to take.
    • Ask how long you should take the medicine and how much you should take. It may be safe to take it for a short time.

Watch for problems

Call your doctor if you have symptoms that your heart failure is getting worse, including the following:

  • You gain weight suddenly, such as 3 lb (1.4 kg) or more in 2 to 3 days.
  • You have new shortness of breath, a cough, or problems eating.
  • Your ankles are more swollen than usual, and you have to get up more often in the night to urinate.
  • You need to use more pillows to sleep at night.

Over-the-counter medicines you may need to avoid

Pain relievers called NSAIDs

  • Ibuprofen, such as Advil and Motrin
  • Naproxen, such as Aleve
  • Aspirin, such as Bayer
    • If your doctor has told you to take a low-dose aspirin every day for your heart problems, it's probably okay to take it. Low-dose aspirin can help prevent blood clots and may prevent a stroke or a heart attack.
    • Higher doses of aspirin may make your heart failure worse. Do not take aspirin for pain, such as from headaches or arthritis. Use acetaminophen, such as Tylenol, instead.

Cold, cough, flu, or sinus medicines

  • Be sure to check the label. Do not take medicines that contain pseudoephedrine, ephedrine, phenylephrine, or oxymetazoline, such as:
    • Sudafed.
    • Nose sprays (decongestants), such as Afrin and Dristan.
    • Herbal remedies, such as ma huang and Herbalife.
  • Make sure your cough and cold medicines don't contain aspirin or ibuprofen.

Antacids or laxatives that contain sodium

  • Check the label for sodium or saline. Examples include:
    • Antacids, such as Alka-Seltzer.
    • Laxatives, such as Fleet Phospho-Soda.

Prescription medicines you may need to avoid

Pain relievers

  • Celecoxib
  • Etodolac
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Nabumetone
  • Naproxen
  • Piroxicam
  • Sulindac


  • These are drugs used to treat a fast or uneven heart rhythm. You may need to avoid:
    • Disopyramide
    • Flecainide
    • Procainamide
    • Propafenone
    • Quinidine

Calcium channel blockers

  • People with a certain kind of heart failure may need to avoid:
    • Diltiazem
    • Verapamil
  • If you need to take a calcium channel blocker for another health problem, such as high blood pressure, your doctor will watch your health carefully.

Certain diabetes medicines

  • You may need to avoid certain medicines such as: footnote 1
    • Pioglitazone.
    • Rosiglitazone.

Certain antibiotics

  • Some antibiotics may interfere with how your body uses the medicine digoxin. If you take digoxin, talk with your doctor before taking antibiotics.



  1. Kaul S, et al. (2010). Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.


ByHealthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Margaret Hetherington, PHM, BsC - Pharmacy

Current as ofFebruary 20, 2015

Current as of: February 20, 2015