Cardiac Medications

Rx pill bottle

If you've had a heart attack, you will most likely be prescribed medication that you will take for the rest of your life.

There are many types and combinations of drugs used to treat coronary artery disease (CAD), and your doctor or other health care provider will decide the best treatment combination for your situation.

The following gives you a quick look at many typical cardiac medications. Your prescription may have a different name from the ones listed on this chart. Brand names commonly available in the U.S. are shown in parentheses after the generic name for each drug.

*Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking. However, the AHA is not recommending or endorsing any specific products. If your prescription medication isn't on this list, remember that your healthcare provider and pharmacist are your best sources of information. It's important to discuss all of the drugs you take with your provider and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting the prescribing doctor.

Anticoagulants

(Also known as Blood Thinners.)

Commonly prescribed include:

  • Apixaban (Eliquis) 
  • Dabigatran (Pradaxa)
  • Edoxaban (Savaysa)
  • Heparin (various)
  • Rivaroxaban (Xarelto)
  • Warfarin (Coumadin)

What the Medication Does

Decreases the clotting (coagulating) ability of the blood. Sometimes called blood thinners, although they do not actually thin the blood. They do NOT dissolve existing blood clots. Used to treat certain blood vessel, heart and lung conditions.

Reason for Medication

  • Helps to prevent harmful clots from forming in the blood vessels.
  • May prevent the clots from becoming larger and causing more serious problems.
  • Often prescribed to prevent first or recurrent stroke.

Antiplatelet Agents and Dual Antiplatelet Therapy (DAPT)

Commonly prescribed include:

  • Aspirin
  • Clopidogrel (Plavix)
  • Dipyridamole (Persantine)
  • Prasugrel (Effient)
  • Ticagrelor (Brilinta)

What the Medication Does

Keeps blood clots from forming by preventing blood platelets from sticking together.

Reason for Medication

  • Helps prevent clotting in patients who have had a heart attack, unstable angina, ischemic strokes, TIA (transient ischemic attacks) and other forms of cardiovascular disease.
  • Can also be prescribed preventively when plaque buildup is evident but there is not yet a major blockage in the artery.
  • Certain patients will be prescribed aspirin combined with another antiplatelet drug – also known as dual antiplatelet therapy (DAPT). 

Dual Antiplatelet Therapy (DAPT)

Some patients who have heart attacks, that have stents placed in their coronary arteries, or undergo coronary artery bypass graft surgery (CABG) are treated with two types of antiplatelet agents at the same time to prevent blood clotting. This is called dual antiplatelet therapy (DAPT).

One antiplatelet agent is aspirin. Almost everyone with coronary artery disease, including those who have had a heart attack, stent, or CABG are treated with aspirin for the rest of their lives. A second type of antiplatelet agent, called a P2Y12 inhibitor, is usually prescribed for months or years in addition to the aspirin therapy.

The type of medication and the duration of your treatment will vary based on your condition and other risk factors. The risks and benefits of DAPT should be discussed with your health care provider.

  • If you did not have a heart attack, but have atherosclerosis in your coronary arteries and had a stent placed, in addition to aspirin, you should be on clopidogrel for at least 1-6 months, depending on the type of stent which was placed, risk of clotting the stent, and bleeding risk. 
  • If you had a heart attack and a coronary artery stent placed, or you are being treated with medical therapy (no stent, clot buster or surgery), in addition to aspirin, you should also be on a P2Y12 inhibitor for 6-12 months. In some cases, it may be advisable to be on DAPT longer. This will need to be discussed with your healthcare provider. The three P2Y12 inhibitors currently available that could be prescribed are clopidogrel, prasugrel, and ticagrelor. Studies have shown that two of these drugs (ticagrelor, prasugrel) are “stronger” than clopidogrel, and are a little better at decreasing the complications of blood clots. These two stronger agents, however, slightly increase bleeding. One of these drugs (prasugrel) should not be used by patients who have had a stroke or a transient ischemic attack (TIA). You will be prescribed the drug that is best for you, based on your risk of blood clots and bleeding. For example, according to the FDA(link opens in new window), clopidogrel does decrease the risk of stroke and MI, but does not change the risk of death for specific patients. The choice of what type of medication, cost of the medication and duration of treatment will be determined in discussions with your health care provider.
  • Some patients who undergo coronary artery bypass surgery may be treated with a P2Y12 inhibitor for a year after the bypass operation. After this, the P2Y12 inhibitor might be stopped, but aspirin is usually continued long-term. Your surgeon will discuss if this treatment will be needed.

These are general recommendations for the duration and type of dual anti-platelet therapy which could be used after coronary artery stenting, heart attack and CABG. Again, it is important to talk to your health care provider about your treatment plan.

Print a patient information sheet on DAPT (PDF).

Angiotensin-Converting Enzyme (ACE) Inhibitors

Commonly prescribed include:

  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Enalapril (Vasotec)
  • Fosinopril (Monopril)
  • Lisinopril (Prinivil, Zestril)
  • Moexipril (Univasc)
  • Perindopril (Aceon)
  • Quinapril (Accupril)
  • Ramipril (Altace)
  • Trandolapril (Mavik) 

What the Medication Does

Expands blood vessels and decreases resistance by lowering levels of angiotensin II. Allows blood to flow more easily and makes the heart's work easier or more efficient.

Reason for Medication

  • Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.

Angiotensin II Receptor Blockers (or Inhibitors)

(Also known as ARBs)

Commonly prescribed include:

  • Azilsartan (Edarbi)
  • Candesartan (Atacand)
  • Eprosartan (Teveten)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Olmesartan (Benicar) 
  • Telmisartan (Micardis) 
  • Valsartan (Diovan) 

What the Medication Does

Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin II receptor blockers prevent this chemical from having any effect on the heart and blood vessels. This keeps blood pressure from rising.

Reason for Medication

  • Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.

Angiotensin Receptor-Neprilysin Inhibitors (ARNIs)

ARNIs are a drug combination of a neprilysin inhibitor and an ARB.

Commonly prescribed include:

  • Sacubitril/valsartan (Entresto)

What the Medication Does

Neprilysin is an enzyme that breaks down natural substances in the body that open narrowed arteries. By limiting the effect of neprilysin, it increases the effects of these substances and improves artery opening and blood flow, reduces sodium (salt) retention, and decreases strain on the heart.

Reason for Medication

  • For the treatment of heart failure

Beta Blockers

(Also known as Beta-Adrenergic Blocking Agents)

Commonly prescribed include:

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Betaxolol (Kerlone)
  • Bisoprolol/hydrochlorothiazide (Ziac)
  • Bisoprolol (Zebeta)
  • Metoprolol (Lopressor, Toprol XL)
  • Nadolol (Corgard)
  • Propranolol (Inderal)
  • Sotalol (Betapace)

What the Medication Does

Decreases the heart rate and force of contraction, which lowers blood pressure and makes the heart beat more slowly and with less force.

Reason for Medication

  • Used to lower blood pressure.
  • Used for cardiac arrhythmias (abnormal heart rhythms)
  • Used to treat chest pain (angina)
  • Used to help prevent future heart attacks in patients who have had a heart attack.

Combined Alpha and Beta-Blockers

Combined alpha and beta-blockers are used to treat high blood pressure and heart failure.

Commonly prescribed include:

  • Carvedilol (Coreg, Coreg CR)
  • Labetalol hydrochloride (Normodyne, Trandate)

A noted possible side effect of combined alpha and beta-blockers:

  • May cause a drop in blood pressure when you stand up

Calcium Channel Blockers

(Also known as Calcium Antagonists or Calcium Blockers)

Commonly prescribed include:

  • Amlodipine (Norvasc)
  • Diltiazem (Cardizem, Tiazac)
  • Felodipine (Plendil)
  • Nifedipine (Adalat, Procardia)
  • Nimodipine (Nimotop)
  • Nisoldipine (Sular)
  • Verapamil (Calan, Verelan)

What the Medication Does

Interrupts the movement of calcium into the cells of the heart and blood vessels. May decrease the heart's pumping strength and relax blood vessels.

Reason for Medication

  • Used to treat high blood pressure, chest pain (angina) caused by reduced blood supply to the heart muscle and some arrhythmias (abnormal heart rhythms).

Cholesterol-Lowering Medications

  • Statins: Atorvastatin (Lipitor), Fluvastatin (Lescol), Lovastatin (Mevacor), Pitavastatin (Livalo), Pravastatin (Pravachol), Rosuvastatin (Crestor), Simvastatin (Zocor)
  • Nicotinic acids: Niacin
  • Cholesterol absorption inhibitor: Ezetimibe (Zetia)
  • Combination statin and cholesterol absorption inhibitors: Ezetimibe/Simvastatin (Vytorin)

What the Medication Does

Various medications can lower blood cholesterol levels, but drugs other than statins are usually only used for patients in whom statins are not effective or who have serious side effects from statin therapy. They work in the body in different ways. Some affect the liver, some work in the intestines and some interrupt the formation of cholesterol from circulating in the blood. Watch an animation of how statins work.

Reason for Medication

Used to lower LDL ("bad") cholesterol.

*Some cholesterol-lowering medications may interact with grapefruit, grapefruit juice, pomegranate and pomegranate juice. Please talk to your health care provider about any potential risks. 

Digitalis Preparations 

Commonly prescribed include:

  • Digoxin (Lanoxin)

What the Medication Does

Increases the force of the heart's contractions. Can be beneficial in treating heart failure and irregular heartbeats.

Reason for Medication

  • Used to relieve heart failure symptoms, especially when the patient isn't responding to other standard treatments including ACE inhibitors, ARBs and diuretics.
  • Also slows certain types of irregular heartbeat (arrhythmias), particularly atrial fibrillation.

Diuretics

(Also known as Water Pills)

Commonly prescribed include:

  • Acetazolamide (Diamox)
  • Amiloride (Midamor)
  • Bumetanide (Bumex)
  • Chlorothiazide (Diuril)
  • Chlorthalidone (Hygroton)
  • Furosemide (Lasix)
  • Hydro-chlorothiazide (Esidrix, Hydrodiuril)
  • Indapamide (Lozol) 
  • Metalozone (Zaroxolyn)
  • Spironolactone (Aldactone)
  • Torsemide (Demadex)

What the Medication Does

Causes the body to rid itself of excess fluids and sodium through urination. Helps to reduce the heart's workload. Also decreases the buildup of fluid in the lungs and other parts of the body, such as the ankles and legs. Different diuretics remove fluid at varied rates and through different methods.

Reason for Medication

  • Used to help lower blood pressure.
  • Used to help reduce swelling (edema) from excess buildup of fluid in the body.

Vasodilators

Commonly prescribed include:

  • Isosorbide dinitrate (Isordil)
  • Isosorbide mononitrate (Imdur)
  • Hydralazine (Apresoline)
  • Nitroglycerin (Nitro Bid, Nitro Stat)
  • Minoxidil

What the Medication Does

Relaxes blood vessels and decreases blood pressure. 

A category of vasodilators called nitrates increases the supply of blood and oxygen to the heart while reducing its workload which can ease chest pain (angina). Nitroglycerin is available as a pill to be swallowed or absorbed under the tongue (sublingual), a spray, and as a topical application (cream).

Reason for Medication


(* Some medications are commonly called blood thinners because they can help reduce a blood clot from forming. There are three main types of blood thinners that patients commonly take: anticoagulants like warfarin or heparin, antiplatelet drugs like aspirin, and fibrinolytics like tPA (tissue plasminogen activator). Each type of medication has a specific function to prevent a blood clot from forming or causing a blocked blood vessel, heart attack, or stroke.)