Heart Failure Medications: Types, Benefits, Side Effects, and How to Take Them Safely
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What are heart failure medications?
Heart failure medications are prescription drugs that help a weakened heart pump better, ease symptoms such as breathlessness and swelling, slow the disease, and help people live longer. Most people take several drugs together, often including ACE inhibitors and beta blockers, plus diuretics for fluid. Never stop them without your doctor's advice. [1]
What the research says
A newer combination pill beat a standard first-line drug. In a trial of 8,442 people with heart failure and an ejection fraction of 40% or less, sacubitril-valsartan cut the risk of heart-related death or heart failure hospitalization to 21.8%, versus 26.5% with enalapril — about a 20% lower risk — over a median of 27 months. (McMurray et al., N Engl J Med, 2014) [2]
An SGLT2 inhibitor lowered risk with or without diabetes. In 4,744 people with reduced ejection fraction, dapagliflozin added to usual treatment reduced worsening heart failure or heart-related death to 16.3%, versus 21.2% with placebo (26% lower risk), with similar results in people with and without diabetes. (McMurray et al., N Engl J Med, 2019) [3]
The benefit held across all types of heart failure. A meta-analysis of five trials with 21,947 participants found SGLT2 inhibitors reduced heart-related death or heart failure hospitalization by 23% and first hospitalization by 28%, regardless of ejection fraction. (Vaduganathan et al., Lancet, 2022) [4]
Key takeaways
Heart failure medications cannot cure heart failure, but they slow it down, ease symptoms and help people live longer. [1]
Most people need several medicines at once, because each one does a different job. [1]
ACE inhibitors and beta blockers are common first-line choices for some people, but when the heart's pumping (ejection fraction) is reduced, guidelines recommend four drug groups: an ARNI (or ACE inhibitor or ARB), a beta blocker, an MRA and an SGLT2 inhibitor. [1]
Weigh yourself daily and call your provider if you gain more than 4 pounds (about 1.8 kg). [1]
Never stop a heart failure medicine on your own, even when you feel better. [1]
What are heart failure medications?
Heart failure medications are prescription drugs that help your heart work better when it can no longer pump blood as well as it should. [1]
Heart failure, also called congestive heart failure, is a long-term condition that affects nearly 6 million people in the U.S. [1] Over time, a weak pump lets fluid build up (congestion) in the legs, feet and lungs. This causes shortness of breath, tiredness and swelling. [1]
Heart failure is progressive, which means it gets worse over time. Treatment lowers the risk of serious problems such as organ damage and sudden cardiac arrest. [1] Treatment combines lifestyle changes with medicines, and some people also need surgery. [1]
Why do people with heart failure take several medications?
People with heart failure take several medications because each drug does a different job in the body to manage the condition and its symptoms. [1]
Your provider chooses your medicines based on three things: [1]
What your provider looks at | Why it matters |
Your symptoms | Shows how much help your heart needs right now |
Your other conditions | Diabetes, high blood pressure and kidney disease change which drugs fit best |
How far heart failure has progressed | Later stages often need more medicines |
Your plan can change over time. Your provider may adjust a dose or switch a drug. [1] Many of these medicines lower blood pressure, so your provider will look for a combination that keeps your blood pressure in a normal range. [1]
What is the first drug of choice for heart failure?
For heart failure with reduced ejection fraction, current guidelines recommend starting four drug groups early: an ARNI (or an ACE inhibitor or ARB), a beta blocker, an MRA and an SGLT2 inhibitor. [1]
They help most when you have a reduced ejection fraction. This means the left ventricle — the heart's main pumping chamber — is not pushing out enough blood with each beat. [1]
There is no single path for everyone. Treatment is tailored to you, so ask your provider about the main goals of your plan and how each medicine helps you reach them. [1]
Which medications are used to treat heart failure?
Heart failure medications are grouped into drug classes, and the right mix depends on which type of heart failure you have. [1] A drug class is a group of medicines that work in a similar way or treat the same problem. [1]
Drug class | Examples (brand names) | What it does |
ACE inhibitors | Captopril (Capoten®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), perindopril (Aceon®), quinapril (Accupril®), ramipril (Altace®), trandolapril (Mavik®) | Help the heart pump better, relax blood vessels, control blood pressure, lower heart attack risk, and block stress hormones that worsen heart failure |
ARBs (angiotensin-2 receptor blockers) | Candesartan (Atacand®), losartan (Cozaar®), telmisartan (Micardis®), valsartan (Diovan®) | Help the heart pump better and relax blood vessels so blood flows more easily |
ARNI (ARB + neprilysin inhibitor) | Sacubitril-valsartan (Entresto®) | Preferred first choice for heart failure with a low ejection fraction; works better than an ACE inhibitor and lowers blood pressure |
Beta blockers | Bisoprolol (Zebeta®), carvedilol (Coreg®, Coreg CR®), metoprolol succinate (Toprol XL®), nebivolol (Bystolic®) | Lower the heart's workload, help it pump better, control blood pressure, lower heart attack risk, block stress hormones and keep the rhythm normal |
Digoxin | Cardoxin®, Digitek®, Digox®, Lanoxin® | Slows the heart rate; helps people with atrial fibrillation and those who still have symptoms on other drugs |
Diuretics ("water pills") | Bumetanide (Bumex®), chlorothiazide (Diuril®), hydrochlorothiazide (Esidrix®, HydroDIURIL®), indapamide (Lozol®), furosemide (Lasix®), metolazone (Zaroxolyn®), torsemide (Demadex®) | Remove extra fluid, ease breathing, reduce swelling in the belly, feet and legs, and lower blood pressure |
Hydralazine and isosorbide dinitrate | Hydralazine (Apresoline®, BiDil®), isosorbide dinitrate (Isordil®) | Open blood vessels so blood flows better and lower blood pressure |
I(f) channel inhibitor | Ivabradine (Corlanor®) | Slows the heart rate |
MRAs (mineralocorticoid receptor antagonists) | Eplerenone (Inspra®), spironolactone (Aldactone®) | Block stress hormones that worsen heart failure; raise blood potassium |
SGLT2 inhibitors | Dapagliflozin (Farxiga), empagliflozin (Jardiance) | Lower the risk of being hospitalized for heart failure |
Your provider will explain which of these drugs you need and why. [1] Some people also take other medicines for related heart and blood vessel problems. [1] If you have an irregular rhythm such as atrial fibrillation, our heart arrhythmia guide explains it in more detail.
What are the benefits of heart failure medications?
Heart failure medications ease symptoms, help people live longer and lower the chance of ending up in hospital. [1]
These drugs: [1]
Ease your symptoms
Help you live longer
Improve your quality of life
Lower your risk of hospitalization
Slow the progression of the condition
What are the side effects of heart failure medications?
Heart failure medication side effects depend on the drug class, and having many possible side effects does not mean you will get many of them. [1] Some are more common than others, so ask your provider what to expect from your own medicines. [1]
Body area | Possible side effects |
Heart and circulation | Abnormal rhythm, fast or slow heart rate, palpitations, low or high blood pressure, dizziness, blackouts |
Fluids and blood salts | Dehydration, high potassium (hyperkalemia), low potassium (hypokalemia), peeing more often, kidney problems |
Breathing and throat | Dry, hacking cough; shortness of breath; swelling of the lips, tongue or throat |
Stomach and gut | Nausea, vomiting, diarrhea |
Whole body | Tiredness, headache, muscle cramps, trouble sleeping |
Eyes | Blurred vision or other vision changes |
Hormones and sexual health | Enlarged male breast tissue (gynecomastia), erectile dysfunction, menstrual changes |
Blood sugar | Ketoacidosis; hidden warning signs of low blood sugar in people with diabetes |
Infections | Urinary tract infection, yeast infection |
Pregnancy | Birth defects or fetal death |
Some side effects fade as your body gets used to a medicine. [1] Your provider may also change your drug or dose to help you manage them. [1]
Get emergency help if you notice swelling of your lips, tongue or throat, or if you black out. These reactions need urgent medical attention.
Do heart failure medications interact with other medicines?
Heart failure medications can interact with a wide range of other drugs, including prescription medicines, over-the-counter products and some herbal supplements. [1]
Before you take anything new, ask your provider or pharmacist whether it is safe with your heart failure medicines. [1]
How do you manage heart failure medications day to day?
Managing heart failure medications means taking them exactly as prescribed, tracking your body at home and planning ahead for refills. [1]
Daily checks at home
Check | How to do it | When to act |
Weight | Same time every day; write it in a log | Call your provider if you gain more than 4 pounds (about 1.8 kg) [1] |
Blood pressure | Use a reliable home monitor your provider recommends | Share your log at every visit |
Pulse | Check regularly | Tell your provider about readings that are new or unusual for you |
Blood sugar | Check if you have diabetes | Some drugs can hide signs of low blood sugar [1] |
Standing up | Rise slowly after sitting or lying down | Some drugs cause dizziness with sudden position changes [1] |
Smart medication habits
Refill early. Ask for a refill about a week before you run out, because a pharmacy may need several days. [1]
Keep a medicine list. Write every drug name, dose, how often and when — prescription and over-the-counter. Keep it updated and carry it with you. [1]
Watch your symptoms. If heart failure symptoms get worse, call your provider right away. Note any side effects too. [1]
Speak up about cost or supply. If a medicine is too expensive or your pharmacy cannot supply it, your provider may suggest options. [1]
Tell your provider about pregnancy. Some heart failure drugs cannot be taken during pregnancy, so tell your provider right away if you are or could become pregnant. [1] Our guide to heart disease and pregnancy covers this in more depth.
What lifestyle changes support heart failure medications?
Healthy habits work alongside heart failure medications to help you feel better. [1]
Your mental health matters too. Many people with heart failure feel sad or depressed. [1] Ask your provider about a social worker, online resources or support groups for people living with heart failure. [1] Let loved ones help on harder days. [1] For everyday habits that protect your heart, see our complete heart health guide.
How long do you need to take heart failure medications?
Most people need to take heart failure medications for life, because heart failure is a long-term condition. [1] Your provider will change your medicines and doses as needed. [1]
Can you stop taking heart failure medications?
You should never stop taking a heart failure medication without talking to your provider first, because stopping suddenly can be dangerous. [1]
Feeling better is a good sign — it shows the medicines are working. Keep taking them as prescribed so they can keep doing their job. [1] Your provider will tell you if a drug should be stopped or its dose changed. [1]
When should you call your doctor about heart failure medications?
You should call your doctor whenever you have new or changing symptoms, questions about your doses, or concerns about side effects. [1]
Keep every follow-up appointment. [1] Some heart failure medicines affect the kidneys, so you will need regular blood tests to check kidney function. [1]
Conclusion
Heart failure does not mean your heart has stopped working. It means your heart needs help to pump the blood your body needs, and that is exactly what heart failure medications do. [1] Most people take a combination of drugs, each with its own job. Taken every day — together with daily weight checks, a low-salt diet and regular follow-up — these medicines help you feel better, stay out of hospital and live longer. [1]
Next step: Learn the warning signs, stages and full range of treatments in our Heart Failure: Symptoms, Causes & Treatment Guide, and know when chest symptoms are an emergency with our heart attack symptoms guide. For patient-friendly background, the American Heart Association's medication overview and the NHS heart failure page are also good reads. Bring your medicine list to your next appointment and ask your provider one question: "What is each of my medicines doing for my heart?"
FAQ
What is the most common medication for heart failure?
ACE inhibitors and beta blockers are among the most commonly prescribed heart failure medications, and current guidelines also add an ARNI, an MRA and an SGLT2 inhibitor early. They are especially helpful when the heart's pumping (ejection fraction) is reduced. [1]
Can heart failure medications cure heart failure?
No, heart failure medications cannot cure heart failure. They slow its progression, ease symptoms, improve quality of life and help people live longer. [1]
Why do I have to take so many heart failure pills?
Each heart failure medication does a different job in the body, so most people need several. Your provider picks the mix based on your symptoms, other health conditions and how far the disease has progressed. [1]
What are the most common side effects of heart failure medications?
Low blood pressure and dizziness are common side effects of heart failure medications. Others depend on the drug class and can include a dry cough, potassium changes, tiredness and peeing more often. [1]
Can I stop my heart failure medication if I feel better?
No, you should keep taking your heart failure medication even when you feel better. Feeling better shows the medicine is working, and stopping suddenly can be dangerous. [1]
How long will I need to take heart failure medications?
Most people need to take heart failure medications for life because heart failure is a long-term condition. Your provider may adjust your drugs and doses over time. [1]
Which over-the-counter drugs should I avoid with heart failure?
Heart failure medications can interact with many over-the-counter drugs and some herbal supplements. Ask your provider or pharmacist before taking anything new. [1]
When should I call my doctor about my heart failure medications?
Call your doctor if you have new or changing symptoms, questions about your doses, side effects that worry you, or a weight gain of more than 4 pounds. [1]
What are SGLT2 inhibitors and why are they used for heart failure?
SGLT2 inhibitors are medicines first made for diabetes that also help people with heart failure. They lower the risk of heart-related death and hospital stays, even in people without diabetes.
Do I need blood tests while taking heart failure medications?
Yes. Many heart failure medicines can affect your kidneys and potassium level, so your provider will order regular blood tests, especially after a new medicine or dose change.
Related Reading
Digoxin: Uses, Normal Levels and Toxicity explains digoxin and its levels.
Aldosterone Antagonists: Uses, Types and Side Effects explains aldosterone antagonist medicines.
Inotropes: Types, Uses and Side Effects explains inotropes and how they affect the heart.
BNP Test (B-Type Natriuretic Peptide): Normal Levels and What High BNP Means explains the blood test used to diagnose and track heart failure.
References
Cleveland Clinic. Medications to Help Treat Heart Failure. Cleveland Clinic. Last updated July 15, 2022. https://my.clevelandclinic.org/health/treatments/23528-heart-failure-medications
McMurray JJ, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993-1004. PMID 25176015. https://doi.org/10.1056/NEJMoa1409077
McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008. PMID 31535829. https://doi.org/10.1056/NEJMoa1911303
Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022;400(10354):757-767. PMID 36041474. https://doi.org/10.1016/S0140-6736(22)01429-5
Medical disclaimer
This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Do not start, stop or change any medication without talking to your doctor or pharmacist. If you have chest pain, severe shortness of breath, fainting, or swelling of your lips, tongue or throat, seek emergency care immediately.
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