Medicines for Cardiomyopathy

Common medicines

Your healthcare provider may prescribe one or more of these medicines:

• ACE inhibitors help blood flow more easily. They relax blood vessels and lower blood pressure. This lets the heart pump more blood without doing more work. These medicines also block the effects of stress hormones. These can damage the heart muscle. If you also have diabetes, this protects the kidneys from further damage. Some people who take ACE inhibitors develop a cough.

• Angiotensin receptor blockers (ARBs) work like ACE inhibitors. These are prescribed for some people who can't take ACE inhibitors.

• Angiotensin receptor neprilysin inhibitor (ARNI) is a combination medicine (valsartan/sacubitril). It can lower blood pressure and reduce the work of the heart. It also helps your body get rid of salt (sodium) and water. This prevents buildup of excess fluid.

• Anticoagulants help prevent blood clots. They can occur when blood pools in the heart from impaired pumping, such as when you have atrial fibrillation (AFib). You may need routine blood tests while taking these medicines to see how well they are working, get the dose adjusted, and see if the medicine may be interacting with foods or medicines. Your healthcare team will give you specific instructions.

• Antiarrhythmics may be used to control a fast or irregular heartbeat.

• Beta-blockers slow the heart rate and lower blood pressure. This lessens the work the heart has to do. They may also help keep the heartbeat regular and help the heart pump better. Like ACE inhibitors, beta-blockers also reduce the damaging effects of stress hormones.

• Diuretics help rid the body of excess fluid. Having less fluid to pump makes the heart’s job easier. Getting rid of extra water can also help reduce swelling, bloating, and shortness of breath. These medicines are among the most important in treating heart failure. They help control the balance of fluid with the heart's changing ability to pump.

• SGLT2 inhibitors help get rid of salt and water from the body. They also reduce heart stress. This medicine can improve heart failure symptoms and improve survival.

• Mineralocorticoid receptor antagonists (MRAs) help prevent the body from holding on to salt and water, reduce heart stress, and lower blood pressure.

• Digitalis and digoxin help the heart pump with more strength so it can pump more blood with each beat. Digitalis may also keep the heartbeat regular.

• Combination medicines may be used. For example, isordil/hydralazine can lower blood pressure and reduce the work of the heart.

• Cardiac myosin inhibitors slow heart contractions. They are used for some people with obstructive hypertrophic cardiomyopathy.

Tips for taking your medicines

Use a pillbox to make keeping track of medications easier.

• Make taking your medicines part of your daily routine.

• Take your medicine at the same time or times each day. Make it a habit.

• Read and follow the directions on the label.

• Don’t run out of medicine. Order more medicine when you have a 1- to 2-week supply of pills left. Let your provider know if you are having trouble filling your prescriptions. Use the same pharmacy each time.

• Make sure you understand any interactions your medicines may have. These could be with foods, supplements, or new prescriptions. Talk with your pharmacist and provider.

• Check with your provider about using over-the-counter medicines. Some may have a lot of sodium. This can cause fluid retention and worsening symptoms. Common cough medicines can increase blood pressure, heart rate, and strain on your heart.

• Bring your medicine bottles with you to each healthcare visit. Ask questions about your medicines. Make sure you understand what you are taking, why you are taking it, and when you should be taking it.

Coping with side effects

Some of the medicines you take may cause side effects. Talk with your provider about any common side effects. Side effects may include nausea, dry cough, dizziness, muscle cramps, or changes in your heartbeat. If you have any symptoms that bother you after starting a medicine, tell your provider right away. Your provider may be able to adjust your dosage or give you a different medicine. Never stop taking your medicine or change your dose on your own.