What are some common heart disease medications?

If you’ve been diagnosed with heart disease, your healthcare provider will likely prescribe medication to help manage your condition. There are many different medications that can be used in the treatment of heart disease.

Healthcare providers may prescribe antiarrhythmic medications for heartbeat abnormalities like:

• Atrial fibrillation
  
• Atrial flutter
• Ventricular tachycardia
• Ventricular fibrillation
• SVT/supraventricular tachycardia
• Frequent premature ventricular contractions (PVCs)

These drugs help to regulate heart rhythm by modifying the electrical impulses that control the heart (electrical conduction system and electricity). Some example of drugs in this category include:

• Adenosine (Adenocard, Adenoscan)
  
• Digoxin (Lanoxin)
• Disopyramide (Norpace, Rythmodan)
• Flecainide (Tambocor)
• Mexiletine (Mexitil, Namuscla)
• Propafenone (Rythmol)
• Quinidine
• Amiodarone (Pacerone)
• Dofetilide (Tikosyn)
• Sotalol (Betapace)
• Metoprolol (Lopressor, Toprol)
• Diltiazem (Cardizem)
• Verapamil

Commonly called blood thinners, anticoagulants make it more difficult for blood to clot. Healthcare providers may prescribe them to reduce the risk of clots forming, to help prevent existing clots from growing larger or to lower the likelihood of stroke. Anticoagulants are commonly used to treat atrial fibrillation and flutter, and they’re prescribed to help prevent stroke and clots in the heart or lungs.

Some examples of anticoagulants include:

• Apixaban (Eliquis)
  
• Argatroban (Acova)
• Bivalirudin (Angiomax)
• Dabigatran (Pradaxa)
• Desirudin (Iprivask)
• Edoxaban (Savaysa) 
• Heparin (Lovenox and others)
• Rivaroxaban (Xarelto)
• Warfarin (Coumadin)

During the 1960s, scientific evidence that aspirin could provide heart health benefits first emerged, and since then, low-dose aspirin therapy has become a common treatment for heart disease. Most often, healthcare providers recommend it to reduce the risk of blood clots in people who already have coronary heart disease. This is known as secondary prevention, and it helps to prevent another heart attack or stroke. Aspirin is also used to help treat peripheral vascular disease, such as blockages in the leg vessels or carotid arteries.

Another type of medication used to reduce the risk of blood clots, antiplatelet agents prevent platelets from sticking together. Healthcare providers may prescribe them for people who have previously had a heart attack or stroke, as well as for individuals who have plaque buildup but haven’t developed a blockage in an artery.

Some common antiplatelet agents include:

• Clopidogrel (Plavix)
  
• Dipyridamole (Persantine) - rarely used
• Prasugrel (Effient)
• Ticagrelor (Brilinta)

For high blood pressure and heart failure, healthcare providers may prescribe angiotensin-converting enzyme (ACE) inhibitors to help lower blood pressure and improve heart function. These medications reduce levels of the hormone angiotensin II, which causes blood vessels to expand, allowing blood to pass through more freely.

The following are some commonly prescribed ACE inhibitors:

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

Another option for treating heart failure and hypertension, angiotensin II receptor blockers, or ARBs, also relax and widen blood vessels, but they do so in a different way than ACE inhibitors. Instead of lowering levels of angiotensin II, ARBs block it from binding to receptors in the heart and blood vessels, which helps to improve heart function.

Some ARBs that healthcare providers may prescribe include:

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

For the treatment of heart failure, healthcare providers may prescribe angiotensin receptor-neprilysin inhibitors or ARNIs. These drugs combine an ARB with a medication that interferes with the actions of the enzyme neprilysin. Currently, sacubitril/valsartan (Entresto) is the only ARNI approved by the U.S. Food and Drug Administration (FDA). ARNI  drugs have the potential to help improve heart function, quality of life, and reduce heart failure admissions to the hospital.

Also referred to as beta-adrenergic blocking agents, beta blockers reduce heart rate and the force with which the heart muscle contracts. These effects lower blood pressure and can aid in the treatment of hypertension, arrhythmia and chest pain. Healthcare providers may also prescribe beta blockers to reduce the risk of future heart attacks in individuals who have already had one.

There are many beta blocker medications, including:

• Acebutolol (Sectral)
  
• Atenolol (Tenormin)
• Betaxolol (Kerlone)
• Bisoprolol/hydrochlorothiazide (Ziac)
• Bisoprolol (Zebeta)
• Carvedilol (Coreg)
• Esmolol (Brevibloc)
• Metoprolol (Lopressor, Toprol XL)
• Nadolol (Corgard)
• Nebivolol (Bystolic)
• Penbutolol (Levatol)
• Propranolol (Inderal)
• Sotalol (Betapace)

Sometimes called calcium antagonists or calcium blockers, calcium channel blockers reduce the amount of the mineral calcium that gets deposited in the heart. Healthcare providers prescribe these drugs for chest pain, high blood pressure and some abnormal heart rhythms.

Examples of calcium channel blockers include:

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

Commonly called water pills, diuretics help the body eliminate sodium and fluid by increasing urination. For people with high blood pressure, diuretics can ease stress on the heart. Healthcare providers may also prescribe these drugs for people who experience swelling due to a heart condition or worsening shortness of breath due to fluid in the lungs or other body parts.

Some diuretics that may be used in the treatment of heart disease include:

• Acetazolamide (Diamox)
  
• Amiloride (Midamor)
• Bumetanide (Bumex)
• Chlorothiazide (Diuril)
• Chlorthalidone (Hygroton)
• Furosemide (Lasix)
• Hydrochlorothiazide (Esidrix, HydroDiuril)
• Indapamide (Lozol)
• Metolazone (Zaroxolyn)
• Spironolactone (Aldactone)
• Torsemide (Demadex)

High levels of LDL cholesterol and/or low levels of HDL cholesterol can increase the risk of heart disease or raise the likelihood for heart attack and stroke in people who already have heart disease. Statins interfere with the production of cholesterol in the liver and are the most commonly prescribed cholesterol-lowering medications.

Examples of statins include:

• Atorvastatin (Lipitor)
  
• Fluvastatin (Lescol)
• Lovastatin (Mevacor, Altoprev)
• Pitavastatin (Livalo, Zypitamag)
• Pravastatin (Pravachol)
• Rosuvastatin (Crestor, Ezallor Sprinkle)
• Simvastatin (Flolipid, Zocor)

When statins aren’t effective on their own, healthcare providers may recommend other cholesterol-lowering medications, like the cholesterol absorption inhibitor ezetimibe (Zetia). They may also recommend combination medications that contain statins and other cholesterol-lowering drugs.

There are also newer generations of cholesterol-lowering agents called PCSK9 inhibitors, which are administered as an injection under the skin every three months. These include Praluent and Repatha.

Another newer medication is bempedoic acid (Nexletol). Taken daily as an oral medication, this drug may be used with diet and other medicines to treat certain patients with heart disease who need help lowering cholesterol levels.

For chest pain associated with heart problems, doctors may prescribe vasodilators, drugs that relax blood vessels to lower blood pressure to help with angina. Drugs that belong in this category include:

• Hydralazine (Apresoline)
• Isosorbide dinitrate (Isordil)
• Isosorbide mononitrate (Imdur)
• Nitroglycerin (Nitro-Bid, Nitrostat)
• Ranolazine (Ranexa)

Healthcare providers consider a number of factors when prescribing medications for heart disease. Your age, health history, the type of heart disease you have and your heart disease risk factors are some of the things that will help determine which medications are best for you.

In addition to medication, your healthcare provider may recommend other interventions, including lifestyle changes like quitting smoking, improving your diet and getting regular exercise. You may also benefit from other treatments, like surgery and cardiac rehabilitation.

Discuss your treatment options with your healthcare provider to get on the path to managing heart disease.

Updated August 2023.