Primary Source: https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/cardiac-medications
* 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.
Rivaroxaban (Xarelto)
Dabigatran (Pradaxa)
Apixaban (Eliquis)
Heparin (various)
Warfarin (Coumadin)
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.
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.
Aspirin
Clopidogrel (Plavix®)
Dipyridamole
Prasugrel (Effient)
Ticagrelor (Brilinta)
Keeps blood clots from forming by preventing blood platelets from sticking
together.
Helps prevent clotting in patients who have had a heart attack, unstable angina,
ischemic strokes, TIA (transient ischemic attacks, or "little strokes")
and other forms of cardiovascular disease.
Usually prescribed preventively when plaque buildup is evident but there is
not yet a major obstruction 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)
Patients who have had heart attacks, patients who are treated with stents in their coronary arteries, and some patients who undergo coronary artery bypass graft surgery (CABG) are treated at the same time with two types of antiplatelet agents 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 a discussion with your healthcare provider weighing the risks of potential bleeding complications.
These are general recommendations for the duration and type of dual anti-platelet therapy which should be used after coronary artery stenting, heart attack and CABG. Again, it is important to talk to your doctor about your specific treatment plan.
Benazepril (Lotensin)
Captopril (Capoten)
Enalapril (Vasotec)
Fosinopril (Monopril)
Lisinopril (Prinivil, Zestril)
Moexipril (Univasc)
Perindopril (Aceon)
Quinapril (Accupril)
Ramipril (Altace)
Trandolapril (Mavik)
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.
Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.
Candesartan (Atacand)
Eprosartan (Teveten)
Irbesartan (Avapro)
Losartan (Cozaar)
Telmisartan (Micardis)
Valsartan (Diovan)
Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin
II receptor blockers prevent this chemical from having any effects on the heart
and blood vessels. This keeps blood pressure from rising.
Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.
ARNIs are a new drug combination of a neprilysin inhibitor and an ARB.
Sacubitril/valsartan (Entresto)
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.
For the treatment of heart failure
Acebutolol (Sectral)
Atenolol (Tenormin) - 25-100 mg qd
Betaxolol (Kerlone)
Bisoprolol/hydrochlorothiazide (Ziac)
Bisoprolol (Zebeta)
Metoprolol (Lopressor, Toprol XL) - 50-200 mg qd
Nadolol (Corgard) - 20-240 mg qd
Propranolol (Inderal) - 40-240 mg qd
Sotalol (Betapace)
Decreases the heart rate and cardiac output, which lowers blood pressure and
makes the heart beat more slowly and with less force.
Used to lower blood pressure.
Used with therapy for cardiac arrhythmias (abnormal heart rhythms) and in treating
chest pain (angina).
Used to prevent future heart attacks in patients who have had a heart attack.
Generic name - carvedilol, Common brand names - Coreg*
Generic name - labetalol hydrochloride, Common brand names - Normodyne*, Trandate*
Used as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure.
A noted possible side effect of combined alpha and beta-blockers:
Amlodipine (Norvasc, Lotrel)
Diltiazem (Cardizem, Tiazac)
Felodipine (Plendil)
Nifedipine (Adalat, Procardia)
Nimodipine (Nimotop)
Nisoldipine (Sular)
Verapamil (Calan, Verelan)
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.
Used to treat high blood pressure, chest pain (angina) caused by reduced blood supply to the heart muscle and some arrhythmias (abnormal heart rhythms).
Statins: Atorvastatin (Lipitor), Rosuvastatin (Crestor)
Nicotinic Acids: Lovastatin (Advicor)
Cholesterol Absorption Inhibitors: Ezetimibe/Simvastatin (Vytorin)
Various medications can lower blood cholesterol levels, but drug other than statins should only be used for patients in whom statins are not effective enough or who have serious side effects due to 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.
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.
Lanoxin
Increases the force of the heart's contractions, which can be beneficial in
heart failure and for irregular heartbeats.
Used to relieve heart failure symptoms, especially when the patient isn't
responding to ACE inhibitors and diuretics.
Also slows certain types of irregular heartbeat (arrhythmias), particularly
atrial fibrillation.
Amiloride (Midamor)
Bumetanide (Bumex)
Chlorothiazide (Diuril) - 125-500 mg qd
Chlorthalidone (Hygroton)
Furosemide (Lasix) - 20-40 mg qd
Hydro-chlorothiazide (Esidrix, Hydrodiuril) - 12.5-50 mg qd
Indapamide (Lozol)
*Spironolactone (Aldactone) - 25-100 mg qd
Causes the body to rid itself of excess fluids and sodium through urination.
Helps to relieve 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.
Used to help lower blood pressure.
Used to help reduce swelling (edema) from excess buildup of fluid in the body.
Isosorbide dinitrate (Isordil)
Nesiritide (Natrecor)
Hydralazine (Apresoline)
Nitrates
Minoxidil
Relaxes blood vessels and increases the supply of blood and oxygen to the heart
while reducing its workload. Can come in pills to be swallowed, chewable tablets
and as a topical application (cream).
Used to ease chest pain (angina)