When taken exactly as prescribed, medications can do wonders. They can help prevent heart attack and stroke. They can also prevent complications and slow the progression of coronary heart disease.
In these lists of medications used to treat arrhythmias, we've included generic names first, with some common brand names in parentheses.
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 doctor and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting your doctor.
Antiarrhythmic drugs
Symptomatic tachycardias and premature beats may be treated with a variety of antiarrhythmic drugs. These may be given intravenously in an emergency situation or orally for long-term treatment. These drugs either suppress the abnormal firing of pacemaker tissue or depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry.
In patients with atrial fibrillation, a blood thinner (anticoagulant or antiplatelet agent such as aspirin) is usually added to reduce the risk of blood clots and stroke.
When tachycardias or premature beats occur often, the effectiveness of antiarrhythmic drug therapy may be gauged by electrocardiographic monitoring in a hospital, by using a 24-hour Holter monitor or by serial drug evaluation with electrophysiologic testing.
The relative simplicity of antiarrhythmic drug therapy must be balanced against two disadvantages. One is that the drugs must be taken daily and indefinitely. The other is the risk of side effects. While side effects are a risk of all medication, those associated with antiarrhythmic drugs can be very hard to manage. They include proarrhythmia, the more-frequent occurrence of preexisting arrhythmias or the appearance of new arrhythmias as bad as or worse than those being treated.
Some commonly prescribed antiarrhythmic drugs include (generic name first; common brand names in parentheses – read drug brand name disclaimer above):
- Amiodarone (Cordarone, Pacerone)
- Bepridil Hydrochloride (Vascor)
- Disopyramide (Norpace)
- Dofetilide (Tikosyn)
- Dronedarone (Multaq)
- Flecainide (Tambocor)
- Ibutilide (Corvert)
- Lidocaine (Xylocaine)
- Procainamide (Procan, Procanbid)
- Propafenone (Rythmol)
- Propranolol (Inderal)
- Quinidine (many trade names)
- Sotalol (Betapace)
- Tocainide (Tonocarid)
Symptomatic tachycardias and premature beats may be treated with a variety of antiarrhythmic drugs. These may be given intravenously in an emergency situation or orally for long-term treatment. These drugs either suppress the abnormal firing of pacemaker tissue or depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry.
In patients with atrial fibrillation, a blood thinner (anticoagulant or antiplatelet agent such as aspirin) is usually added to reduce the risk of blood clots and stroke.
When tachycardias or premature beats occur often, the effectiveness of antiarrhythmic drug therapy may be gauged by electrocardiographic monitoring in a hospital, by using a 24-hour Holter monitor or by serial drug evaluation with electrophysiologic testing.
The relative simplicity of antiarrhythmic drug therapy must be balanced against two disadvantages. One is that the drugs must be taken daily and indefinitely. The other is the risk of side effects. While side effects are a risk of all medication, those associated with antiarrhythmic drugs can be very hard to manage. They include proarrhythmia, the more-frequent occurrence of preexisting arrhythmias or the appearance of new arrhythmias as bad as or worse than those being treated.
Some commonly prescribed antiarrhythmic drugs include (generic name first; common brand names in parentheses – read drug brand name disclaimer above):
- Amiodarone (Cordarone, Pacerone)
- Bepridil Hydrochloride (Vascor)
- Disopyramide (Norpace)
- Dofetilide (Tikosyn)
- Dronedarone (Multaq)
- Flecainide (Tambocor)
- Ibutilide (Corvert)
- Lidocaine (Xylocaine)
- Procainamide (Procan, Procanbid)
- Propafenone (Rythmol)
- Propranolol (Inderal)
- Quinidine (many trade names)
- Sotalol (Betapace)
- Tocainide (Tonocarid)
Calcium channel blockers
Calcium channel blockers, also known as "calcium antagonists," work by interrupting the movement of calcium into heart and blood vessel tissue. Besides being used to treat high blood pressure, they're also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).
Some commonly prescribed calcium channel blockers include (generic name first; common brand names in parentheses – read drug brand name disclaimer above):
- Amlodipine (Norvasc, Lotrel)
- Diltiazem (Cardizem, Cartia, Dilacor, Diltia, Tiazac)
- Felodipine (Plendil)
- Isradipine (Dynacirc)
- Nicardipine (Cardene)
- Nifedipine (Adalat, Procardia)
- Nimodipine (Nimotop)
- Nisoldipine (Sular)
- Verapamil (Calan, Covera, Isoptin, Verelan)
Beta-blockers
Beta-blockers decrease the heart rate and cardiac output, which lowers blood pressure by blocking the effects of adrenalin. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris.
Some commonly prescribed beta-blockers include (generic name first; common brand names in parentheses – read drug brand name disclaimer above):
- Acebutolol (Sectral)
- Atenolol (Tenormin)
- Betaxolol (Kerlone)
- Bisoprolol/hydrochlorothiazide (Zebeta, Ziac)
- Carteolol (Cartrol)
- Esmolol (Brevibloc)
- Metoprolol (Lopressor, Toprol)
- Nadolol (Corgard)
- Penbutolol (Levatol)
- Pindolol (Visken)
- Propranolol (Inderal)
- Timolol (Blocadren)
Anticoagulants
Anticoagulants (blood thinners) work by making it harder for the blood to clot, or coagulate. They aren't designed to dissolve existing blood clots. They prevent new clots from forming or existing clots from getting larger. Because a common type of stroke is caused by a blood clot obstructing blood flow to the brain, anticoagulants are often prescribed for people with certain conditions to prevent the occurrence of a first stroke or to prevent the recurrence if the patient has already had a stroke. Anticoagulants are also given to certain people at risk for forming blood clots, such as those with artificial heart valves or who have atrial fibrillation.
Warfarin (brand name Coumadin – read drug brand name disclaimer) is one of the most commonly-prescribed anticoagulant drugs. Aspirin is frequently recommended in addition to or instead of prescription anticoagulants.
Learn more about atrial fibrillation medications
Both these drugs interfere with your blood's clotting ability. Aspirin has an antiplatelet effect. That means it makes your blood platelets less likely to stick together and form clots. Aspirin is less likely to cause abnormal bleeding, but warfarin seems to be more effective at preventing clot-caused strokes.
Warfarin is an anticoagulant or blood thinner. That means it reduces your blood's ability to clot (coagulate). Stroke can be prevented in most AF patients by using blood thinners. Most people over age 60 who have atrial fibrillation can be treated with a blood thinner. These drugs must be very carefully monitored because too much blood thinner can cause abnormal bleeding.
To be sure you're getting the right amount of blood-thinning medication, your doctor will do a test called a Prothrombin Time. (This test is also called "ProTime" or "PT.") The results of this test may be reported to you as an "INR" number. By using an INR (International Normalized Ratio), your doctor can keep your blood clotting at a safe and effective level. Your INR should usually test between 2.0 and 3.0.
A Patient's Guide to Taking Warfarin
Taking medications
- Take all medications exactly as prescribed.
- Never stop taking any prescription medication without first consulting your healthcare provider.
- If you have any side effects, tell your healthcare provider about them.
- Tell your healthcare provider about all your other drugs and supplements, including over-the-counter medications and vitamins. Track all your medicines online with Heart360 or download our printable medication log.
- Medications
Many rhythm disorders, especially tachycardias, respond to medications. Several drugs are now available and more are being developed. These drugs can't cure the arrhythmia, but they can improve symptoms. They do this by preventing the episodes from starting, decreasing the heart rate during the episode or shortening how long the episode lasts. - Sometimes it's hard to find the best medication for a child. Several drugs may need to be tried before the right one is found. Some children must take medication every day; others need medications only when they have a tachycardia episode. It's very important to take the medication as prescribed.
- All medications have side effects, including drugs to treat arrhythmias. Most of the side effects aren't serious and disappear when the dose is changed or the medication is stopped. But some side effects are very serious. That's why some children are admitted to the hospital to begin the medication. If your child is prescribed medication, it's very important that your child take the medication just the way the doctor prescribes it.
- It's often necessary to monitor how much of a drug is in your child's blood. The goal is to make sure there's enough of the drug to be effective, but not so much that harmful side effects occur. These blood tests require taking a small amount of blood from a vein or the finger. It's a good idea to talk to your child about this before the doctor visit.
Learn about warfarin and other medications for atrial filibrillation
Tools For Patients
Keeping Track / Developing a System
Keeping track of your prescribed medications can be challenging — especially if you're taking several different medicines. Writing things down will make managing your medications a lot easier. Use our printable medicine tracker to stay organized.
Lowering High Blood Pressure
By treating high blood pressure, you can help prevent a stroke, heart attack, heart failure, kidney failure and peripheral artery disease. Our printable blood pressure tracker will help you monitor your blood pressure and record suggestions from your doctor.
Managing Cholesterol Levels
This printable chart will track your cholesterol at each of your medical appointments, along with the efforts you're making to manage your levels, to help you monitor your success.
Manage Everything Online
Heart360 is a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, weight and physical activity. Set goals and track your progress each time you enter your levels. Print comprehensive reports to share with your healthcare team. And manage accounts for your loved ones as well as yourself.
Keeping Track / Developing a System
Keeping track of your prescribed medications can be challenging — especially if you're taking several different medicines. Writing things down will make managing your medications a lot easier. Use our printable medicine tracker to stay organized.
Lowering High Blood Pressure
By treating high blood pressure, you can help prevent a stroke, heart attack, heart failure, kidney failure and peripheral artery disease. Our printable blood pressure tracker will help you monitor your blood pressure and record suggestions from your doctor.
Managing Cholesterol Levels
This printable chart will track your cholesterol at each of your medical appointments, along with the efforts you're making to manage your levels, to help you monitor your success.
Manage Everything Online
Heart360 is a one-stop, easy-to-use set of online tracking tools for medications, blood pressure, cholesterol, blood glucose, weight and physical activity. Set goals and track your progress each time you enter your levels. Print comprehensive reports to share with your healthcare team. And manage accounts for your loved ones as well as yourself.
What is Compliance?
Compliance simply means that you follow the recommendations made by your team of healthcare professionals. These recommendations often include taking medications as well as making lifestyle changes such as quitting smoking, eating right, maintaining a healthy weight and getting the right kind of physical activity. Maintaining a healthy lifestyle can give you the edge in the fight against heart disease and stroke. Follow your doctor's advice carefully, and if you don't understand something, ask questions. Let your doctor be your coach. It's your health. It's your heart.
Are you a "Good Dog" or "Bad Dog" when it comes to your medication? Take our "Good Dog, Bad Dog Compliance Quiz" and find out how well you follow your healthcare professional's recommendations.
Quick Tips for Compliance
Taking medicine may be new to you, and there may be a lot to remember. For example, why are you taking it? What time should you take it? How often do you take it and how many pills do you take? It's important to take medicine the right way — just as prescribed.
If you don't take medicine as directed, what could happen? First of all, it may not work. It could also cause side effects that may be mild — or very harmful. Without knowing it, you could counteract one medicine by taking it with another. Medicine can also make you feel sick or dizzy.
How can I remember to take my medicine?
- Take it at the same time every day.
- Take it along with other daily events, like brushing your teeth.
- Use special pill boxes that help you keep track, like the ones divided into sections for each day of the week (which can be found at a drugstore).
- Ask people close to you to help remind you.
- Keep a "medicine calendar" near your medicine and make a note every time you take your dose.
- Put a sticker or reminder note on your medicine cabinet or refrigerator. You can buy a small magnetized white board with dry-erase markers and list your pills on the board. Each day, mark the board when you take your medication. It's an easy way to keep track, and at the end of the day, just erase the board and start over again in the morning.
Quick Tips for Medication Use
- Understand your medication. Know what it's for, and how and when you're supposed to take it.
- Ask your doctor or pharmacist whether to take your medicine with food or on an empty stomach.
- Make an instruction sheet for yourself by taping a sample of each pill you take on a sheet of paper and writing down all the information about each pill to remind you.
- Get some colored labels and stick them on your medicine bottles to simplify your routine. For example, blue can be for morning, red for afternoon and yellow for bedtime.
- Ask your pharmacist to help you come up with a coding system for your medications that makes them easier to take.
- Purchase timer caps for pill bottles to remind you when to take medication.
Also,
- You can buy many types of pill containers. Some even beep when it's time to take medication. Ask your pharmacist about these aids.
- If your medication routine is too complicated, ask your physician or pharmacist to help you simplify the process, such as reducing the number of daily doses that you need.
- If your medications are too expensive, ask your physician or pharmacist about finding financial assistance.
- If you're away from home a lot, make sure you carry enough of your medication with you to take the prescribed doses while you're out. Some pharmacists will prepare blister paks for daily or weekly medications. Ask your pharmacist about this.
- If you're using a commercial pill dispenser, set a regular time each week to refill it; for example, every Friday night after you eat.
- If you have trouble understanding your physician or pharmacist, ask a friend or loved one to go with you and help you.
- If you don't feel like your medication is making a difference, talk to your physician and ask why.
- Do not stop any medications without talking to your physician or healthcare provider.
Quick Tips for Lifestyle Changes
- Ask your physician or healthcare professional to help you with nutrition and physical activity advice that is right for you.
- Learn to read food labels so you'll be able to limit the satuated fat, trans fats, cholesterol, added sugar and sodium in your diet.
- Eat fruits, vegetables and, fat-free and low-fat dairy, fiber-rich and whole-grain, high-fiber foods most often and fish (preferably oily) at least twice a week. Eat fish twice a week. Choose fat-free, 1 percent fat and low-fat dairy products and lean meats and poultry without skin. Limit partially hydrogenated and hydrogenated vegetable oils, coconut oil, palm oil and foods made these oils, egg yolks, organ meats, shellfish, salt and salty foods and sugar sweetened foods and beverages,
- Keep a diary or record of all your nutrition and physical activity efforts. When you see your successes written down, it will encourage you to continue your good habits.
- Ask your physician if you should have a home blood pressure monitoring kit to see if your medicine is working.
- If you're monitoring your blood pressure at home, ask when you can expect to see the results from your medicine.
- If you don't feel like you're making progress, talk to your physician and ask why your progress is slow.
- If you're having trouble giving up smoking, ask your physician if you can take a smoking cessation drug to help.
- Become an active participant in making treatment decisions. Overcome barriers that keep you from following your doctor's orders.
Medication Safety Tips
- Store your medicine the way your doctor or pharmacist tells you. ALWAYS keep it away from heat, light and moisture.
- Never store medications in the bathroom. There's too much moisture there.
- Don't carry medicines next to your body. That can raise the temperature and cause some medications to break down.
- Keep track of what pills you can and can't take together, including over-the-counter medicines.
- Always get your prescription filled on time so you don't run out. Missing even one day can make a difference in the effectiveness of many medications.
- Don't stop taking a prescribed medication because your symptoms have gone away.
- Use one pharmacy for all your medicines. This will help ensure that you don't take conflicting medications.
- Try to see the same pharmacist each time.
- If you have any questions about your pills, make a note to remind yourself to ask your doctor or pharmacist.
- Tell your doctor if you have any side effects.
- Don't take more of your medicine than the prescribed dose.
- Ask your doctor or pharmacist before buying a new over-the-counter medicine, such as an antihistamine or "cold tablets," to be sure they won't interfere with your prescribed medicine.
- Always check with your doctor before you stop taking a medicine.
- Make sure that ALL of your doctors know ALL of the medicines you're taking — both prescription and over-the-counter drugs.
- Be sure to tell your doctor or pharmacist of any nutritional supplements and/or herbal preparations you're taking. Some nutritional supplements and herbals can interact with prescribed medications and cause them to be less effective.
- Know the names and doses of the medicines you're taking.
- Keep all medicines out of the reach of children.
- ALWAYS let your physician know about any side effects you experience.
- If you have a chronic condition, talk to your physician to determine whether your condition limits your ability to do regular physical activity in any way. Such a conversation should also help you learn about appropriate types and amounts of physical activity.
- Throw away any medicines that aren't currently prescribed to you.
- Don't share your medications with anyone else. What's right for you may be deadly for them.
- Ask for your pharmacist's advice before crushing or splitting tablets. Some should only be swallowed whole.
- If you store your medications in any container other than the one they come in, be sure to show the container to your pharmacist to ask if it will change the effectiveness of your medication.
Questions To Ask Your Doctor About Your Medication
Taking medications isn't as simple as swallowing a pill. Medicines can only help if you take them as prescribed. Take part in decisions regarding your treatment, follow the treatment plan you and your doctor agree on, watch for problems and become actively involved in solving them with your healthcare team. By following these guidelines, you can help reduce your risk of heart disease and stroke and achieve the fullest benefits from your treatment plan. Review the following questions with your healthcare team and take an active role in your health.
- What is the name of the medicine?
- Is this the brand or generic name?
- What is the medicine supposed to do?
- How and when do I take it, and for how long?
- What foods, drinks, other medicines or activities should I avoid while taking this medicine?
- Is there any written information available about the medicine?
- What happens if I miss a dose of my medicine?
- How often will I have to get the medication refilled?
- How will I know that my medication is working?
- What are the risks of taking this medication?
- What are the risks of NOT taking this medication?
- Are there less expensive medications for my condition?
Get a Medication Checkup
Prescription and over-the-counter medicines help many people live longer, more active lives. When you take the right medicines the right way, they're safe and effective tools for good health. But using them incorrectly can harm you. The more medicines you take, the greater your risk of problems. You can protect your health by getting a checkup on your medications. Take these simple steps as outlined by the National Council on Patient Information and Education.
- Make an appointment with your doctor or your pharmacist.
- Put all your prescription and over-the-counter drugs in a bag. Be sure to include:
Cold remedies (liquid, capsules and tablets)
Laxatives and upset stomach aids
Other prescription or over-the-counter drugs you may be taking
Vitamins and nutritional supplements
Herbal remedies
- Remember to take all of your medications in their original containers if possible.
- Take the bag to your doctor or pharmacist and get him or her to go over all of your medicines with you.
- Ask questions about anything you don't understand.
A checkup like this gives you the opportunity to ask your healthcare professional or pharmacist important questions about your medications. It can help you find dangerous medicine combinations you may be taking, medicines you may not need to take anymore, improper dosages of medicines, and mistakes that you may be making in taking them. Call your doctor or pharmacist today to schedule a medication checkup and take charge of your health.
