Heart Association Warns of Drug Interactions That Can Increase Heart Failure Risk

Taking Advil, Sudafed, or many other common medications used for a wide range of ailments, may worsen heart failure or even trigger it, according to the findings of new research. 

In a scientific statement issued this week in the medical journal Circulation, the American Heart Association indicates that most heart failure patients take an average of six different medications, and warn that drug interactions are one of many factors that increase the risk of heart failure or exacerbate the condition.

Researchers found nearly 90 different medications may increase the risk of heart failure or worsen the condition. Many of the over-the-counter (OTC) and prescription drugs that made the list are commonly taken by Americans, including Advil, antidepressants and other drugs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil and Aleve are among the list of evidence-based medications that can negatively affect heart failure, by leading to sodium and water retention or exacerbating underlying myocardial dysfunction. Even OTC heartburn medications may have high levels of sodium that are usually restricted in heart failure patients.

Pseudoephedrine, known under brand names like Sudafed, is commonly sold OTC for colds and flu and can increase blood pressure, posing a risk to heart patients.

Other prescription drugs having a potential impact on worsening heart failure include, anesthesia medications, the diabetes medication Metformin, beta blockers for hypertension, doxorubicin and other anticancer drugs, interferon, interleukin-2, tricyclic antidepressants, the antipsychotic clozapine, Lithium and Albuterol, which is commonly used to treat asthma.

The statement also notes alternative and complimentary medicines should be scrutinized, as some may be dangerous for heart failure patients, including ginseng, St. John’s wort and green tea that interfere with common heart failure medications.

The varying medications and herbal treatments can be dangerous in several ways, including being toxic to the heart muscles or changing how the muscle contracts, interacting with medications used to treat heart failure reducing their benefits, and having high levels of sodium than is recommended for heart failure patients.

Researchers say the extensive list is important to offer healthcare providers information on drugs that may cause exacerbate heart failure to assist in improving the quality of care for patients.

This is the first-ever authoritative overview of which drugs are known to affect heart failure. Heart failure is a common, costly debilitating condition and is the leading discharge diagnosis among patients over 65.

The cost of treating heart failure in Medicare patients reach $31 billion and is expected to increase to $53 billion by 2030.

Study authors call on healthcare professionals to conduct a comprehensive medication review during each visit to ensure patients aren’t using any potentially harmful combinations. They also suggest using a medication flow sheet for each patient, detailing the name, dose and type of medication. This could be used as a way to enhance medication safety.

The American Heart Association statement also called on doctors to stop prescribing medications to patients without a clearly defined need and to avoid prescribing new drugs to address side effects of other drugs.