Heart failure

Common side effects of heart failure medication

Most medicines have unwanted effects but everyone reacts differently and not everyone is aware of side effects. Because people with heart failure take many different drugs, they may well experience unusual sensations or new feelings. Some reactions such as extreme sun-sensitivity are clearly a side effect of medication, but other feelings such as confusion or memory loss may be part of having heart failure. One or two people said they had experienced no side effects from their medication, and several recognised that it was difficult to tell the difference between symptom and side effect.

A wide range of side effects were reported by people we spoke to, some of which caused them to stop taking a particular medicine and try another one. Some of the side effects mentioned were due to the medicines having their desired effect but too strongly. Dizziness and nausea were common after first starting to take beta-blockers, though these feelings usually stopped once people had got used to the drugs. Some felt that their heart had been slowed too far by beta blockers, making it difficult for them to do all their normal activities.
Other side effects on the cardiovascular system included headache and cold extremities. However, one man said he experienced hot feet and had to sleep with his feet outside the bed covers or use a cold water bottle to cool them down. A young man felt that spironolactone caused him chest pain, so he was switched to eplerenone. People who were taking anti-platelet drugs or anti-coagulants to thin the blood found that they bruised easily or bled a lot from the slightest injury; some had nose bleeds (see ‘Warfarin, digoxin, aspirin and statins’).

Diuretics are intended to rid the body of excess fluid so that going to the loo is the primary effect of the medication. In the hours immediately following taking the diuretic people we spoke with had to empty their bladder repeatedly. This was inconvenient and interfered with their activities or their sleep, depending on what time of day they took the medicine. Those who took the drug in the mornings either delayed going out or had to make sure they knew where the nearest toilet was if they did go out (see ‘Beta blockers, ACE inhibitor, diuretics and aldosterone antagonists’). Some found this less of an issue after lowering the dose of their diuretic. Altering the timing of the tablets could help avoid this problem interfering with trips away from home.
Too high a dose of diuretics could make people dehydrated and several had been advised to keep their fluid intake up, despite taking diuretics, but achieving the right fluid balance could be difficult. Brian explained: “On the one hand you’re taking diuretic pills to get rid of water, on the other hand you’ve got to drink a lot of water; slight paradox there”.

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Diuretics, ACE inhibitors and the anti-arrhythmic drug amiodarone can affect kidney function. A man said his diuretic dose had subsequently been halved; a woman had been referred to a specialist for investigations. For more about reduced kidney function see 'Kidney health'.

Many people had experienced a persistent dry cough when taking certain ACE inhibitors; one woman said that clopidogrelhad made her cough, although this is rare. Some said that their doctor had taken them off their ACE inhibitor and prescribed an alternative type of medicine (see also ‘Beta blockers, ACE inhibitor, diuretics and aldosterone antagonists’).

Side effects on the digestive system were also reported. These included indigestion, nausea, loss of appetite, taste changes, and constipation or diarrhoea. Many found it difficult to pinpoint the cause of some side effects like the loss of appetite; one woman found that the smell of food put her off eating though she still liked cooking. Another person found that he often hated food that he had liked before he was ill, which he blamed on all the drugs he was taking. 


Last reviewed April 2016.
Last updated April 2016.



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