Medications Used to Treat Heart Failure

Studies have shown that some classes of drugs are best for treating heart failure.

The goal of heart failure treatment is to improve your quality of life and help you live longer. Treating heart failure with medication can:

• Reduce fatigue
• Reduce shortness of breath 
• Reduce fluid retention
• Improve your energy level so you can be physically active
• Stop or slow the progress of the disease, even if you have no signs or symptoms

People with heart failure need more than one medication. Each treats a different symptom or factor and has its own instructions. These medications work together to improve heart function. They reduce the risk of complications, helping you live a better life while managing heart failure.

You and your caregivers should work with your health care team to understand your medications. 

• Know the dose and when and how often to take them. 
• Tell your health care team about all medications you are taking, including:
  • Over-the-counter medications
  • Supplements 
  • Herbal medicines 
• Take your medications as prescribed. If your medications are ever changed, ask why the change is needed.

Don’t stop taking your medications or change how you take them without talking to your health care professional or pharmacist.

The following list covers the typical medications used to treat heart failure at different stages. Your prescription might have a different name from the ones listed here. 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 heart failure medications are summarized in this section. For your information, we have included generic names as well as trade names. However, the American Heart Association is not recommending or endorsing any products. If your medication isn’t on this list, remember that your health care professional and pharmacist are your best sources of information. Discuss all your medications with your health care team to understand their desired effects and possible side effects.

Print a medication tracker (PDF)

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)

ACE inhibitors and ARBs lower blood pressure by widening blood vessels. This reduces the heart’s workload and helps keep heart failure from getting worse. You may be prescribed either an ACE inhibitor or an ARB, but not both. They should not be taken together.

Commonly prescribed ACE inhibitors include:

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

Commonly prescribed ARBs include:

• Candesartan (Atacand)
• Losartan (Cozaar)
• Valsartan (Diovan)

Sacubitril/valsartan (Entresto)

Sacubitril/valsartan (Entresto) replaces an ACE inhibitor or ARB. It is a combination medication called an angiotensin-receptor neprilysin inhibitor (ARNI). Sacubitril blocks neprilysin. Valsartan is the ARB. Neprilysin breaks down substances in the body called natriuretic peptides. Blocking neprilysin increases the impact of these substances, which: 

• Improves artery opening and blood flow
• Reduces sodium retention 
• Decreases strain on the heart 

Beta blockers (also known as beta-adrenergic receptor-blocking agents)

Beta-blockers prevent the heart from beating too quickly and forcefully. Commonly prescribed beta-blockers include:

• Bisoprolol (Zebeta)
• Carvedilol (Coreg)
• Carvedilol phosphate (Coreg CR)
• Labetalol (Trandate)
• Metoprolol succinate (Toprol XL and Kapspargo Sprinkle)
• Metoprolol tartrate (Lopressor)
• Nebivolol (Bystolic)
• Propranolol (Inderal, Inderal LA, and InnoPran XL)

Bisoprolol (Zebeta), carvedilol (Coreg) and metoprolol succinate (Toprol XL and Kapspargo Sprinkle) have the best evidence for helping people with heart failure. Other beta-blockers (not listed above) are usually avoided in heart failure because they can overstimulate the beta-receptor. This can lead to unwanted effects such as increased heart rate.

Aldosterone Antagonists

Aldosterone antagonists (also called mineralocorticoid receptor antagonists or MRAs) are water pills that help to lower high blood pressure. They also improve heart function in people with heart failure, even if their blood pressure is normal or they aren’t retaining extra fluid. Commonly prescribed aldosterone antagonists include:

• Spironolactone (Aldactone)
• Eplerenone (Inspra)

SGLT2 Inhibitors

Sodium-glucose cotransporter-2 (SGLT2) inhibitors help control blood sugar and may reduce body weight and blood pressure. First developed for diabetes, they also improve heart function and ease symptoms in people with heart failure. SGLT2 inhibitors approved for heart failure include:

• Dapagliflozin (Farxiga)
• Empagliflozin (Jardiance)
• Sotagliflozin (Inpefa)

Hydralazine and isosorbide dinitrate

These medications are vasodilators, which widen blood vessels. This helps blood flow more easily and reduces the heart’s workload.

Some vasodilators, such as nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate), mainly widen veins but also widen coronary arteries. Others (hydralazine) work mostly on the arteries.

You may need to take two vasodilators if your blood pressure is high or if your symptoms affect your daily activities.

Research has shown that these medications, when added to standard therapy, can: 

• Reduce death 
• Reduce hospitalization 
• Improve quality of life for people with a reduced ejection fraction, especially those of African ancestry

These medications are prescribed as two separate medications (hydralazine and isosorbide dinitrate) or as a single pill containing both (BiDil).

Diuretics (also called water pills)

Heart failure can cause extra fluid retention. Diuretics or “water pills” cause the body to rid itself of extra fluids and sodium through urination.

It decreases fluid buildup in the lungs and other parts of the body, such as the ankles and legs. This can help to reduce the heart’s workload. Different diuretics remove fluid at varied rates and through different methods.

The most prescribed diuretics for heart failure include:

• Furosemide (Lasix)
• Bumetanide (Bumex)
• Torsemide (Demadex)

Other diuretics you may see include:

• Metolazone (Zaroxolyn)
• Chlorothiazide (Diuril)
• Amiloride (Midamor)
• Chlorthalidone (Hygroton)
• Hydrochlorothiazide or HCTZ (Esidrix, Hydrodiuril)
• Indapamide (Lozol)
• Triamterene (Dyrenium)

Other heart failure medications

Ivabradine (Corlanor)
This medication is known as an If channel blocker. This drug slows the heart rate differently from beta-blockers, without lowering blood pressure.

Digoxin (Lanoxin)
This medication might strengthen the heart’s pumping action and reduce a heart rate that’s too fast. The level of digoxin in the body must be checked with a blood test. Too much digoxin in the blood may cause side effects, including: 

• Loss of appetite
• Nausea
• Vomiting 
• Headaches
• Too fast or too slow heart rhythm 

Report any side effects of this medication to your health care professional right away.

Vericiguat (Verquvo) 
This medication is known as a soluble guanylate cyclase (SGc) inhibitor. It increases the amount of nitric oxide, a natural chemical in the body that widens blood vessels. This helps reduce the heart’s workload.

Other medications

Your health care professional may prescribe other medications for health conditions that may occur with heart failure. These include:

• Potassium and magnesium supplements: Diuretics can remove potassium and magnesium from the body. These supplements can keep your levels normal during treatment.
• Anticoagulants (also called blood thinners): They help prevent blood clots from forming and blocking blood flow. Clots may form in the legs, lungs or heart. If a clot breaks off and gets stuck inside a blood vessel that supplies the brain, a stroke can result. Anticoagulants are used in heart failure patients with: 
  • Atrial fibrillation
  • An artificial heart valve
  • Blood clots 
  • A high risk for blood clots 
• Cholesterol-lowering medications (statins): You may take these if you have high cholesterol or have had a heart attack. They are not used to treat heart failure but other conditions. These medications help prevent plaque from forming. This helps lower the risk of heart attack and stroke.
• Oxygen therapy delivers concentrated oxygen to the lungs. This helps increase the amount of oxygen that can get into the blood. Oxygen therapy can improve shortness of breath and improve your ability to be physically active.

More medication information:

• Download our Medication Tracker (PDF)
• Find more descriptions of how these medications help with other cardiovascular diseases.