Heart attack

Medication for heart attacks & side effects

People who have had a heart attack will usually need to take medication for the rest of their lives.

Most will take a combination of drugs including' an antiplatelet drug, such as aspirin abd clopidogrel, which interferes with the blood's clotting mechanism; an ACE (angiotensin converting enzyme) inhibitor, which relaxes the arteries enabling blood to flow through them more freely; a beta blocker which slows down the heartbeat' and a statin which helps to lower cholesterol. Those who are likely to experience angina will be given a nitrate (GTN tablet or spray). Other drugs for lowering high blood pressure may also be prescribed.

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Some people need to take many medicines, others will be able to reduce the number as they progress. It will depend on many things including; how much the heart was damaged by the heart attack and the state of the coronary arteries.

A few of the people we talked to said they didn't like the idea of taking tablets long term and were hoping to reduce them eventually, but all considered the drugs to be essential. Some people had reduced the number of pills or the dosages of the pills they took over time and most said they got used to taking their tablets. Those who took several pills a day said they used a pill box to help them to remember to take their medication.

Sometimes when people are taking several different drugs, getting the right combination of medicines can take time. Because drugs affect people differently it is important to talk to a doctor about any side effects - it is often possible to change medication.

Some people we spoke to experienced no or few side effects. Among those who did have side effects, many persevered with the medicine and said they were tolerable when weighed against the possibility of having another heart attack.

The side effects we were told about included' dizziness, cough, feeling sluggish, upset stomach, headaches, arm pains, flu like symptoms, blurred vision, wind, forgetfulness, irritability and tiredness. A couple of people became constipated or were allergic to aspirin and were prescribed a different antiplatelet drug, such as clopidogrel.

When a metal mesh (called a stent) is used to keep the artery open after an angioplasty, an anti-clotting drug usually clopidogrel is prescribed for a year afterwards. Bruising was one reported side effect and Neil found that it clashed with the medicine he was taking for his acid reflux. Anti-clotting drugs such as clopidogrel may also present problems for people needing surgery.

A few had experienced dizziness or a persistent dry cough when taking certain ACE inhibitors. One man talked to his doctor who prescribed a different ACE inhibitor and his cough disappeared. Another was advised by his doctor to take the pill in the evening so he would be less likely to notice the dizzy spells. One man said he could feel his heart beat loudly when he took the ACE inhibitor at bedtime, which frightened him until he was told that it was normal.

Many people who took a beta-blocker said they felt sluggish and felt it slowed them down. Others noticed their hands and feet got cold easily. A few who had low blood pressure had problems at first getting the right dosage of beta blocker. Beta blockers can cause erectile difficulties in men. None of the men we interviewed mentioned that they had experienced this side effect.

Many people said they did not experience side effects from the statin. Two women had noticed that they were losing some of their hair every time they brushed it and one also had nightmares. Another whose muscles had seized up was taken off the statin by her doctor. One man had pains in his leg and his tongue became swollen.

Many who took a GTN spray felt reassured by having the spray with them all the time in case of an angina attack. One man who wasn't prescribed nitrate drugs when he left hospital asked his GP for a GTN spray for his own reassurance and peace of mind. Some said that they had an immediate headache when they took nitrate drugs, which passed in a few minutes, or they felt light headed and weak for a short time, but all said it was effective in controlling their angina attack.

One man explains that at first he had trouble taking the GTN spray but he had now got used to it. A few people said that they felt uncomfortable about taking the spray if they had an angina attack in a public place.

Last reviewed June 2017.

Last updated June 2017.


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