Health Library Taking Your Medicines Properly When You Have Heart FailureFrom Healthwise

Medicines do not cure heart failure. However, they can make you feel better, help your heart work better, and help you live longer.

Key points

• Take a list of your medicines or bring your medicines with you when you visit your doctor. Include both medicines that were prescribed to you by other doctors and any nonprescription medicines and natural supplements that you take. Review the list with your doctor and discuss any side effects you are having or need to watch for.
• Make your medicine schedule as simple as possible. Plan times to take your medicines when you are doing other things, like eating a meal or getting ready for bed. This will make it easier for you to remember to take your medicines.
• Talk with your doctor if you are having problems with your medicine schedule. Your doctor may be able to change your medicines or the times you are taking them.
• Talk with your doctor if you have any changes in your health that might affect your heart condition, such as weight gain, side effects of medicines, or another medical condition.
• Use any tools, like daily or weekly "mediset" pill containers, that make taking your medicines simpler.

 What do medicines do for heart failure?
 Why is it important to take my medicines properly?
 How can I take my medicines properly?
 Where to go from here

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Medicines do not cure heart failure. However, they can relieve some symptoms, improve your heart function, slow the progression of the disease, and reduce your risk of early death. The medicines used to treat heart failure work in various ways to help your heart and body function better. The specific medicines that your doctor prescribed for you are based on your specific symptoms, the specific ways your heart functions poorly, and how well you can manage your condition with lifestyle changes.

Several kinds of medicines may be used to treat heart failure.

• Some medicines work by improving the pumping action of the heart. This improves blood flow and helps more oxygen get to your heart and body.
• Some relax your blood vessels so that your heart doesn't have to pump so hard.
• Medicines may help your body get rid of excess fluid that builds up because of heart failure.
• Medicines may also be used to control underlying conditions (such as high blood pressure or high cholesterol) that may contribute to heart failure.

It may take some time and careful, controlled adjustments by you and your doctor to find the right combination, schedule, and dosing of medicine to best manage your heart failure. Once the best medicine program is determined, it is important to follow it exactly as prescribed.

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Medicines work in a delicate balance with each other and with your body. Changes in your medicine schedule or dosage can affect how well the medicines work to control your heart failure and how you feel. If you do not take your medicines properly:

• Your heart failure could get worse.
• Sudden heart failure may develop.
• You could get sick enough that you have to be hospitalized.
• You could even develop additional permanent heart damage.

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Here's how you can get started on taking your medicines properly.

Developing a medicine plan

Work with your doctor to develop your medicine plan. Talk with your doctor about the following when you are developing your medicine plan:

1. Names of all medicines. Get a clear explanation of the action and purpose of each medicine that your doctor prescribes for you. If you understand what you are taking and how it is helping you, it may be easier to stick to your schedule. Write down both the prescription and generic names for your medicines. Have your doctor check the list. You can use this list to verify that the medicines you get from the pharmacy are correct.
2. Medicine schedule. Be sure you understand how much of each medicine to take and when to take each one. Ask your doctor whether you can simplify your pill schedule. This may make it much easier for you to remember to take your medicines as directed. You may be able to substitute longer-acting medicines for shorter-acting ones. Longer-acting, once-a-day medicines are easier for people to remember to take.
3. How to handle missed doses. Talk with your doctor about what you should do if you accidentally miss a dose of a medicine. Discuss what to do for each medicine—it may be different for each one.
4. Medicine costs. If cost is a consideration in developing your medicine plan, ask your doctor whether less expensive, equally effective generic brands would be appropriate for you. Compare prices between several pharmacies, and consider mail-order pharmacies.
5. Medicines to avoid. You may need to avoid certain medicines. Many nonprescription medicines, prescription medicines, and natural supplements can make symptoms of heart failure worse or can react with prescribed medicines. Use the list of medicines to avoid to write down those that you should not take. Check with your doctor before taking any medicines on this list.

Getting organized

Taking medicines properly means taking the right dose of the right medicine at the right time. When you are taking several different medicines, it may be hard to keep the times and dosages straight. To be sure that you are taking your medicines properly, you may want to develop a system to keep track of when and how you take your pills.

1. Make a list of all your medicines. Complete the master list of medicines and keep it up to date. At every visit with your doctor, review your master list of medicines(What is a PDF document?).
2. Plan a daily schedule of medicines. Post your medicine schedule in a prominent place near your medicine cabinet. Take it along when you travel. Record your medicine schedule in a daily planner that has spaces for hourly entries.(What is a PDF document?)
3. Use a pillbox. Get a pillbox that holds a week's worth of pills. This may be especially helpful if you are taking pills every other day.
4. Post reminders. Get sticky note pads and post reminders to take your medicines near clocks or on the bathroom mirror to keep you on schedule.

Taking your medicines

Keep the following in mind as you use your medicine plan.

• Store medicines properly. Keeping medicines in a location that is too hot or too cold may decrease the effectiveness of the medicines. Find out from your doctor or pharmacist how to properly store your medicines. Always remember to store medicines out of the reach of children.
• Watch for side effects. Ask your doctor or pharmacist about what side effects to expect. Be sure to tell your doctor if you are having side effects from your medicines.
• Avoid other medicines. Post your list of medicines to avoid in a place where you can refer to it whenever you need to. Always check with your doctor before taking any additional medicines, prescription or nonprescription. This includes any herbal or "natural" supplements.
• Review your master medicine list. Take your master list with you for each visit with your doctor. Take time to review your list and report any side effects you are having.
• Communicate with your doctor. Notify your doctor immediately if you have any serious side effects. Let your doctor know if you have any changes in your health that might affect your heart condition, such as weight gain or another medical condition.

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Now that you have read the information on taking your medicines properly for heart failure, you are ready to develop your system for taking your medicines properly.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of the pages where you have questions.

If you don't have a medicine plan already, schedule a time with your doctor to develop one.

If you would like more information on taking your medicines properly, the following resource is available:

Organization

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Author:	Robin Parks, MS	Last Updated: September 1, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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