Several groups of medicines are used to treat heart disease. Although many are similar, there are differences which make some more suitable for certain people. Doctors can choose the medicine that will best suit each individual patient.

 

Note: This section does not contain all the available information about

medicines used to treat heart disease. If you have further queries or

concerns about your medicines (including possible side effects),

ask your doctor or pharmacist. Always take your medications as

prescribed by your doctor. 

 

On this page: ACE inhibitors · Angiotensin-2 blockers · Anti-arrhythmic medications · Combination products · Anti-coagulant medications · Blood clotting time · Anti-platelet medications · Beta-blockers · Calcium channel blockers · Cholesterol-lowering agents · Other lipid-lowering drugs · Diuretics · Nitrates

 

Generic name and brand name

All medicines have a generic name and a brand name. For example, the well-known brand Viagra has the generic name sildenafil. Brand names are capitalised, generic names are not. One medicine may have several different brand names – for example, brand names for the anti-inflammatory generic medicine ibuprofen include Nurofen, Motrin and Advil.  

 

It is very important that you know the generic name as well as the strength of your medicines.

 

Keep a list

To reduce the risk of medication errors between your GP and your specialist, you can help by keeping an up-to-date list of all your medicines, including their dose and the frequency with which you take them. Ask your pharmacist if he or she can produce a ‘medilist' for you – for example:

 

 

Drug name	Strength	Breakfast	Noon	Dinner	Bedtime
Metoprolol	50mg	ONE	ONE
Simvastatin	20mg	ONE
Aspirin	300mg	HALF
Ramipril	10mg	ONE
Frusemide	40mg	ONE

 

 

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ACE inhibitors  

What is ACE?

ACE stands for angiotensin-converting enzyme.

 

What do ACE inhibitors do?

These medications inhibit (block) the production of angiotensin – a powerful chemical in the body that has a narrowing effect on the blood vessels.

 

ACE inhibitors dilate (open up) your blood vessels, helping your heart to pump more efficiently. They are very effective in:

 

• treating heart failure
• lowering blood pressure
• helping patients who have had a heart attack.

 

List of medications

Some of these medications are combination products.

 

 

Generic name	Strength	Brand name®
Captopril	12.5 mg, 25 mg, 50 mg (5 mg/ml liquid)	Acenorm, Capoten, Captohexal, Topace
Enalapril	2.5 mg, 5 mg, 10 mg, 20 mg	Alphapril, Amprace, Auspril, Enahexal, Renitec
Fosinopril	10 mg, 20 mg	Monopril
Lisinopril	5 mg, 10 mg, 20 mg	Fibsol, Liprace, Lisodur, Prinivil, Zestril
Perindopril (arginine)	2.5 mg, 5 mg	Coversyl
Perindopril (erbumine)	2 mg, 4 mg, 8 mg	GenPx, Chemmart, Perindo Combi, Terry White
Quinapril	5 mg, 10 mg, 20 mg	Accupril, Asig
Ramipril	1.25 mg, 2.5 mg, 5 mg, 10 mg	Ramace, Tritace
Trandolapril	0.5 mg, 1 mg, 2 mg, 4 mg	Gopten, Odrik

 

 How to take ACE inhibitors  

• Your doctor may start you on a low dose and gradually increase it every few days/weeks, so that you tolerate the medication better. 
• Take your tablets at the same time each day. This produces the best effect on your blood pressure. 
• If you are prone to falling over or dizziness, your doctor may recommend you take your first dose of medication before going to bed, so that your body can get used to the medication.  
• Most ACE inhibitors can be taken either with or between meals.

 

Side effects and adverse reactions

• You may become light-headed or dizzy if your blood pressure is too low. This can happen after your first dose of an ACE inhibitor or after an increase in dose. If this happens, get up slowly from your chair or bed. Do not drive a car or operate dangerous machinery until you know how this medicine affects you.  
• Dry cough, headache, nausea and vomiting. 
• High potassium level in the blood.

 

 Caution – before you start taking the medication, check with your doctor: 

• If you want to take potassium supplements while taking these medicines.  
• If you have a kidney problem or only have ONE kidney.

 

Alert your doctor if you experience: 

• Swollen face, lips, mouth or throat (seek immediate help). 
• Difficulty in breathing (seek immediate help). 
• Skin rash.  
• Yellowing of the whites of the eyes.  
• Lethargy, flu-like symptoms, anaemia.

 

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Angiotensin-2 blockers (A2 blockers)

What is angiotensin?

Angiotensin is a chemical in the body that narrows the arteries.

 

What do A2 blockers do?

Angiotensin 2 blockers prevent the production of angiotensin. This helps the blood vessels to relax, which lowers your blood pressure. 

 

These medications have a similar action to the ACE inhibitors, but tend to block the effects of angiotensin more selectively

 

They are usually better tolerated, and usually used only if a patient is unable to tolerate an ACE inhibitor.

 

 

Generic name	Strength	Brand name®
Candesartan	4mg, 8mg, 16mg	Atacand
Eprosartan	400mg, 600mg	Teveten
Irbesartan	5mg, 150mg, 300mg	Avapro, Karvea
Telmisartan	40mg, 80mg	Micardis, Pritor

 

 

How to take these medications  

• Take your tablets at the same time each day. This produces the best effect on your blood pressure.  
• It does not matter whether you take Angiotensin 2 blockers before or after food.  
• Ask your doctor or pharmacist before taking potassium supplements. 
• Drink enough water during exercise and hot weather, especially if you sweat a lot.  

 

Maximum anti-hypertensive effect occurs about 4-6 weeks after starting treatment.

 

Side effects and adverse reactions  

• Light-headedness, dizziness. If affected, get up slowly from your chair or bed. Do not drive or operate dangerous machinery until you know how this medicine affects you.  
• Headache.  
• High potassium level in the blood. 
•  

 

Caution – before you start taking the medication, check with your doctor: 

... if you have a kidney problem or only have ONE kidney.

 

Alert your doctor if you experience: 

• Skin rash or itchiness.
• Aching muscles or joints, not caused by exercise.
• Yellowing of the skin and/or eyes.
• Symptoms that may indicate kidney disease, such as passing little or no urine, drowsiness, nausea, vomiting.

 

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Anti-arrhythmic medications  

Anti-arrhythmic drugs are used to control the rhythm of the heart. Other medications that also act as anti-arrhythmics include beta-blockers (e.g. Sotolol) and calcium channel blockers (e.g. Verapamil).

 

DIGOXIN (pronounced ‘didge-oxin')

 

 

Generic name	Strength	Brand name®
Digoxin	62.5mcg	Lanoxin PG, Sigmaxin PG (blue tablets)
	250mcg	Lanoxin, Sigmaxin (white tablets)

 

 

Actions  

• Regulates rapid and/or irregular heart rate.
• Improves heart failure.

 

How to take this medication  

• Avoid taking antacids, e.g. Mylanta® or laxatives, e.g. Metamucil® within 2 hours of taking your Digoxin tablets, since the absorption of Digoxin into your body may be reduced and affect how well it works.  
• Take Digoxin with or after food to reduce the chance of nausea.  

 

Your doctor may order a blood test to check your Digoxin level. If the level is too high it can mean that you are more likely to experience side effects, and the dose may need adjusting.

 

Side effects and adverse reactions  

Loss of appetite, tiredness.

 

 

Alert your doctor immediately if you experience blurred vision (seeing a halo around objects), nausea, vomiting, or confusion. 

 

Caution - before you start taking the medication, check with your doctor:  

... if you have any new medications (they may affect the Digoxin level in the body.)

 

AMIODARONE

 

 

 

Generic name	Strength	Brand name®
Amiodarone	100mg 200mg	Aratac, Cardinorm, Cordarone X, GenRx amiodarone, Rithmik

 

 

How to take this medication  

On starting this medication you will usually receive a loading dose

regimen which may mean you take a higher than usual dose for 2-3 weeks. This should then be reduced to a ONCE daily dosing schedule in accordance with your doctor.

 

Amiodarone remains in the body for months after stopping treatment therefore you may still experience side effects or interactions even after stopping treatment.

 

Side effects and adverse reactions  

• Increased sensitivity to the sun. Use a 30+ sunscreen, wear a hat, long sleeves and sunglasses whenever you are in the sun.  
• Headache, nausea, vomiting, sleep disturbances, taste disturbances (metallic).  
• Numbness or tingling in fingers or toes.  
• Eyesight problems - sensitivity, haloes (have regular eye sight tests).  

 

You will need to have regular thyroid function tests as amiodarone can affect the way the thyroid gland works, altering your metabolism.

 

Caution - before you start taking the medication, check with your doctor:  

... if you have a history of hypo- or hyperthyroidism.

 

Amiodarone has the potential to interact with a number of medications.

 

Check with your pharmacist before starting any new medication.

 

Alert your doctor if you experience: 

• Shortness of breath, cough or flu-like symptoms.
• Weakness in walking, muscle cramps or loss of balance.
• Disturbances in heart beat.

 

FLECAINIDE (pronounced ‘flec-an-ide')  

 

 

 

 

Generic name	Strength	Brand name®
Flecainide	50mg 100mg	Flecatab, Tambocor

 

 

Uses  

• To treat serious heart rhythm disturbances.
• To slow down and steady the heart.

 

How to take this medication  

Flecainide is usually taken twice a day with or after food.

 

Side effects and adverse reactions  

• Palpitations, fatigue, chest pain, abdominal pain, constipation, rash, tremor, nervousness and numbness on the body.  
• Development of heart failure.

 

Caution - before you start taking the medication, check with your doctor:

• if you have heart failure, or have had a recent heart attack.
• if you are taking cimetidine for indigestion.

 

Alert your doctor if you experience: 

... a sore throat, flu-like illness, fatigue or anaemia within a few weeks of starting medication. You may need to have your blood checked.

 

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Combination products  

To help patients improve compliance in taking their medications,

some pharmaceutical companies create combined products to try and

reduce the number of tablets. Some of these combination products are listed below:

 

 

Brand name®	Strength	Generic ingredients
Accuretic	10mg/12.5mg, 20mg/12.5mg	Quinapril (ACE inhibitor) + Hydrochlorothiazide (Diuretic)
Atacand Plus	16mg/12.5mg	Candesartan (A2 blocker) + Hydrochlorothiazide (Diuretic)
Avapro HCT Karvezide	150mg/12.5mg 300mg/12.5mg	Irbesartan ACE (A2 blocker) + Hydrochlorothiazide (Diuretic)
Coversyl Plus	2.5mg/0.625mg, 5mg/1.25mg	Perindopril (arginine; ACE inhibitor) + Indapamide (Diuretic)
GenPx, Chemmart,Perindo Combi, Terry White	4mg/1.25mg	Perindopril (erbumine; ACE inhibitor) + Indapamide (Diuretic)
Hydrene	25mg/50mg	Hydrochlorothiazide (potassium sparing diuretic) + Triamterene (Diuretic)
Micardis Plus	40mg/12.5mg 80mg/12.5mg	Telmesartan (A2 blocker) + Hydrochlorothiazide (Diuretic)
Moduretic	5mg/50mg	Amiloride (potassium sparing diuretic) + Hydrochlorothiazide (Diuretic)
Renitec Plus	20mg/6mg	Enalopril (ACE inhibitor) + Hydrochlorothiazide (Diuretic)
Teveten Plus	600mg/12.5mg	Eprosartan (A2 blocker) + Hydrochlorothiazide (Diuretic)

 

 

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Anti-coagulant medications

What do anti-coagulants do?

Anti-coagulant drugs prevent or delay clotting of the blood. Clots are made up of tiny blood cells called platelets, which clump together and mix with a protein called fibrin. Anti-coagulants prevent fibrin from forming, by affecting the clotting factors produced by the liver.

 

WARFARIN

 

 

 

Generic name	Strength	Colour	Brand name®
Warfarin	1mg	Beige	Coumadin
	2mg	Mauve	Marevan (3mg (blue) and 5mg (pink) strengths available
	5mg	Green

 

 

Note: The two different brands of warfarin are NOT interchangeable.

 

Uses  

For treating atrial fibrillation/flutter (also known as AF). This is characterised by a fast and irregular heart beat. Warfarin can prevent the tiny clots that are easily formed as a result of the turbulent flow of blood through the heart chambers, during AF.  

• After artificial heart valves are implanted. Warfarin prevents clots forming on the valve.  
• After a blood clot in the legs (deep venous thrombosis, or DVT).  
• After a blood clot in the lungs (pulmonary embolism, or PE).  

 

How to take this medication  

• Take your warfarin tablets ONCE a day in the evening.  
• Make sure you have all blood tests ordered by your doctor (see Blood clotting time). You will need regular blood tests while you are taking  this medicine. Your doctor will tell you how often and advise what dose to take until your next blood test.  
• Do not take any new medicines without asking advice from your doctor or pharmacist. This includes herbal and vitamin preparations and non-steroidal anti-inflammatory medicines e.g. Nurofen, Naprogesic.  
• Aspirin is best avoided, unless your doctor advises otherwise.   
• Avoid extremes of diet or alcohol.  
• For pain control, take Paracetamol.   
• Remind other doctors and your dentist that you take Warfarin and that you will take longer to stop bleeding than before.  
• If you forget a dose, take it within the next 2-3 hours. If you miss the dose one day, telephone your GP the next morning for advice on what to do. Never take double the dose if unsure.  
• Always carry an identifying card or disc with you stating that you currently take Warfarin.

 

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Blood clotting time: INR

The INR (International Normalised Ratio) is a measure of how long it takes your blood to clot compared with standard time. Your doctor may want your blood to take twice as long as the normal time to clot. This means the aim is to have an INR of 2.

 

Your doctor will advise you what INR is necessary for you. Be aware that many medicines and some foods can change the INR or clotting time. Ask your doctor or pharmacist if in doubt.  

 

Side effects and adverse reactions  

• Increased risk of bleeding/bruising.
• Rarely, skin rash.

 

Alert your doctor if you experience: 

• Bleeding from the bowels (bowel motions are like tar), or dark urine.  
• Severe bruising. 

 

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Anti-platelet medications

What do anti-platelets do?

Anti-platelet medications prevent clots forming. They act on the platelets – small blood cells that are important for helping the blood to clot.

 

These medications make the surface of the platelet less sticky.

 

ASPIRIN 

 

 

 

Generic name	Strength	Brand name®
Aspirin	100mg	EC Astrix (capsules), Cartia, Cardiprin
	100mg	Astrix (tablets), Cardiprin
	300mg	Aspro, Disprin, Solprin

 

 

How to take this medication  

• Take the prescribed dose ONCE a day, with or after food (unless your doctor tells you otherwise).  
• Effervescent tablets should be dissolved in water before taking.

 

Side effects and adverse reactions  

• Stomach irritation and discomfort.  
• Wheeze and difficulty breathing.  
• Increased risk of bleeding.  

 

Caution - before you start taking the medication, check with your doctor:

• If you have stomach or duodenal ulcers.
• If you are an asthmatic.
• If you are taking any other medications that affect bleeding.

 

Alert your doctor if you experience:  

• Bleeding from the bowels (bowel motions are like tar), dark urine.
• Severe bruising.

 

 

CLOPIDOGREL    

 

 

Generic name	Strength	Brand name®
Clopidogrel	5mg	Plavix, Iscover

 

 

Uses  

• Taken in addition to aspirin, clopidogrel prevents blood clots forming on newly implanted stents.  
• Used in strokes and heart disease in patients who are allergic to aspirin.

 

How to take this medication  

Take the prescribed dose ONCE a day, with or after food.

 

Duration of treatment

After having a stent, take for at least 12 months, then as directed by your cardiologist.

 

Side effects and adverse reactions  

• Indigestion, stomach or intestinal pain, nausea or vomiting.  
• Diarrhoea.  
• Skin rash.  

 

Caution - before you start taking the medication, check with your doctor:

• If you have stomach or duodenal ulcers.
• If you are taking any other medications that affects bleeding.

 

Alert your doctor if you experience:  

• Any sign of infection such as sore throat, fever and chills.
• Prolonged or abnormal bleeding or bruising.
• Signs of jaundice, e.g. yellow eyes or skin, dark urine or light coloured stools.

 

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Beta-blockers

 What do beta-blockers do?

• Beta-blockers block the effects of adrenaline on your heart and blood vessels, reducing the work your heart has to do.
• They have a protective effect after a heart attack (e.g. Metoprolol), and are also useful in preventing attacks of angina (e.g. Atenolol).
• They also have an effect in lowering raised blood pressure.
• Some beta-blockers can be used in heart failure to help the heart work more effectively (e.g. Bisoprolol, Carvedilol and Metoprolol XL).
• Some beta-blockers are able to help control heart rhythm disturbances (e.g. Sotolol).

 

 

Generic name	Strength	Brand name®
Atenolol	50mg	Anselol, Atehexal, Noten, Tenormin, Tensig
Bisoprolol	1.25mg, 2.5mg, 5mg, 10mg	Bicor
Carvedilol	3.125mg, 6.25mg, 12.5mg, 25mg	Dilatrend, Kredex
Metoprolol (Tartrate)	50mg, 100mg	Betaloc, Lopressor, Metrol, Minax, Metohexal
Metoprolol (Succinate)	23. 5mg, 4 .5mg, 95mg, 190mg	Toprolol XL (Controlled Release)
Oxprenolol	20mg, 40mg	Corbeton
Pindolol	5mg, 15mg	Barbloc, Visken
Propranolol	10mg, 40mg, 160mg	Deralin, Inderal
Sotalol	80mg, 160mg	Cardol, GenRx, Sotacor, Solavert, Sotahexal

 

 

How to take these medications  

• Your doctor may start you on a low dose and gradually increase the
• dose every few days/weeks so that you tolerate the medication better.  
• Take your tablets at the same time each day. This produces the best effect on your blood pressure.  
• Do not stop taking your medicines without first discussing it with your doctor.  
• Sotalol is usually taken twice a day on an empty stomach. Take at least 2 hours after consuming calcium, milk and antacids.  

 

Side effects and adverse reactions  

• Tiredness when exercising.  
• Low blood pressure – dizziness and drowsiness. If affected, get up slowly from your chair or bed. Do not drive a car or operate dangerous machinery until you know how this medicine affects you.  
• Stomach upsets, nausea and vomiting.  
• Very slow heart beat.  
• Impotence (inability to maintain an erection).  
• Decreased concentration.  
• Coldness in your extremities, (e.g. cold hands and feet).  
• Nightmares, hallucinations and sleeplessness.  

 

Caution – before you start taking the medication, check with your doctor:

• If you suffer from asthma/chronic obstructive pulmonary disease (COPD) or have breathing problems. Beta-blockers can make these conditions worse.  
• If you are a diabetic and you have a 'hypo', you may not get the usual warning of a racing heart.  
• If you suffer from Raynaud's disease or peripheral vascular disease.  

 

Alert your doctor if you experience:  

• Slow heart rate.
• Cold hands and feet.
• Breathing difficulties.
• Blurred vision, coloured haloes around lights, flashing or flickering of light.

 

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Calcium channel blockers  

Calcium is needed in the body for all muscles including the heart

muscle to be able to contract and work properly.

 

What do calcium channel blockers do?

Calcium channel blockers dilate (open up) your blood vessels by reducing the amount of calcium entering the heart cell - this causes the vessels to relax. As a result, these drugs have the effect of increasing the blood supply to the heart, and reducing the work the heart has to do to pump blood around the body.

 

They add to the effects of nitrates, but act in a different way.

 

 

Generic name	Strength	Brand name®
Amlodipine	5mg, 10mg	Norvasc
Felodipine	2.5mg, 5mg, 10mg	Plendil ER, Felodur ER
Lercandipine	10mg, 20mg	Zanidip
Nifedipine	10mg, 20mg, 30mg, 60mg	Adalat, Adalat Oros, Adifin, Adifin XL Nyefax, Nifecard, Nifehexal, Nypine
Diltiazem	60mg, 180mg, 240mg, 360mg	Cardizem, Cardizem CD, Coras, Dilzem, Dilzem CD, Diltahexal, Diltahexal CD, Vasocardol, Vasocardol CD
Verapamil	40mg, 80mg, 120mg, 160mg, 180mg, 240mg	Anpec, Anpec SR, Cordilox SR, Isoptin, Isoptin SR, Veracaps SR

 

 

Uses  

• To prevent angina.
• To lower high blood pressure.

 

How to take these medications

Some forms must be swallowed whole and not chewed. Check with your pharmacist or doctor.

 

Side effects and adverse reactions  

• Low blood pressure causing dizziness, light-headedness or faintness (especially). If affected, get up slowly from your chair or bed. Do not drive a car or operate dangerous machinery until you know how this medicine affects you.  
• Headache.  
• Flushing.  
• Constipation especially with Diltiazem and Verapamil.  

 

Caution – before you start taking the medication, check with your doctor:

• If you have heart failure.
• If you have bradycardia
• If you have second or third degree atrio-ventricular block.

 

Alert your doctor if you experience:  

• Muscle cramps.
• Slow heart rate.
• Swelling of the ankles.
• Shortness of breath.

 

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Cholesterol (lipid)-lowering agents  

‘Blood lipids' is the name given to all the fatty substances in the

blood, including HDL cholesterol, LDL cholesterol and triglycerides.

 

The overall aim of diet and drug treatment is to lower the amount of cholesterol in the blood, especially the LDL cholesterol. The main groups of drugs that doctors use to treat high cholesterol are called statins. However, these don't suit everyone, and doctors sometimes have to use an alternate type of drug to reduce cholesterol levels.

 

STATINS (HMG-CoA reductase inhibitors)  

 

 

Generic name	Strength	Brand name®
Atorvastatin	10mg, 20mg, 40mg, 80mg	Lipitor
Fluvastatin	20mg, 40mg	Lescol, Vastin
Pravastatin	10mg, 20mg, 40mg	Pravachol
Rosuvastatin	10mg, 20mg, 40mg	Crestor
Simvastatin	5mg, 10mg, 20mg, 40mg, 80mg	Lipex, Simvar, Zimstat, Zocor

 

 

How to take these medications

 

• Take your medication with a full glass of water with or after your evening meal.
• Atorvastatin and Rosuvastatin may be taken at other times of the day if prescribed.
• These medicines should be taken in conjunction with a low-fat diet.
• Avoid drinking grapefruit juice as this may increase statin levels.

 

Side effects and adverse reactions

 

• Constipation, diarrhoea, wind, stomach upset, nausea.
• Headache, dizziness, inflammation of the liver, muscle ache.

 

Caution - before you start taking the medication, check with your doctor:

• If you have known kidney or liver disease.
• If you are taking other medications: check they are compatible with statins. Caution with certain antibiotics, antifungal.

 

People of Asian descent may need treatment with lower doses.

 

Alert your doctor if you experience:

Muscle aches, tenderness or pain, unusual tiredness, fever.

 

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Other drugs to reduce blood lipids

 

EZETIMIBE (E-zet-im-ibe)

 

 

Generic name	Strength	Brand name®
Ezetimibe	10mg	Ezetrol

 

 

How to take this medication

 

Take ONCE a day, usually in addition to a statin.

 

Side effects and adverse reactions

 

• Headache, diarrhoea.
• When taken with a statin, increased risk of sore, achey muscles.

 

 

Caution - before you start taking the medication, check with your doctor:

 

... if you have known liver disease.

 

See your local pharmacist for more information on:

 

• Nicotinic acid
• Fibrates - Fenofibrate, Gemfibrozil
• Cholestyramine

 

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Diuretics - fluid tablets

 

 

Generic name	Strength	Brand name ®
Amiloride	5mg	Midamor, Kaluril
Amiloride + Hydrochlorothiazide	50mg/5mg	Amizide, Moduretic
Bumetanide	1mg	Burinex
Frusemide	20mg, 40mg, 500mg	Frusehexal, Frusemide-BC, Frusid, GenRx Frusemide, Lasix, Urex, Uremide
Hydrochlorothiazide	25mg	Dithiazide
Indapamide	2.5mg 1.5mg (SR)	Dapa-tabs, Natrilix, Napamide Natrilix SR
Spironolactone	25mg, 100mg	Aldactone, Spiractin
Triamterene + Hydrochlorothiazide	50mg/25mg	Hydrene

 

 

What do diuretics do?

• Cause your kidneys to remove excess water and salt from your body into your urine.
• Reduce swelling and water retention (e.g. in your legs or in your lungs) often caused by heart disease.
• Treat high blood pressure.

 

How to take these medications

 

• If you are taking the diuretic twice daily, take the second dose in the afternoon, rather than in the evening or at night. This avoids the need to get up during the night to urinate.

 

• Be aware of the dose you should be taking after each visit to the doctor since your dose may change as the diuretic takes effect.

 

• You may be prescribed a potassium supplement; e.g. Slow K® or Span K® whilst you are taking your diuretic. Be aware that the dose of the potassium supplement may change depending upon the dose of your diuretic and also other medicines. Your doctor will check your electrolyte balance in your blood.

 

• Do not stop taking your medicines without discussing with your doctor

 

• Weigh yourself regularly and report any rapid loss or increase in weight to your doctor.

 

Side effects and adverse reactions

 

• Frequent need to pass urine, dry mouth, thirst.

 

• Light-headedness, dizziness. If affected, get up slowly from your chair or bed. Do not drive or operate dangerous machinery until you know how this medicine affects you.

 

Alert your doctor if you experience:

 

• Weakness, tiredness, drowsiness.
• Muscle cramps, pains.
• Gout.
• Fast heart beat.

 

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Nitrates

What do nitrates do?

Nitrates are called vasodilators. They dilate (open up) blood vessels, including the ones carrying blood and oxygen to your heart. They are very useful in relieving angina pain.

 

Some preparations are used on an ‘as required' basis to control angina pain. Others (e.g. patches and sustained-release tablets) deliver a continuous supply of the drug over a longer period.

 

CAUTION: You must not take Viagra, Cialis or Levitra if you are taking any nitrate

Medication. It may lead to a severe drop in your blood pressure, which may be difficult to treat.

 

 

SHORT-ACTING NITRATES 

 

 

Generic name	Strength	Brand name®
Glyceryl Trinitrate (also known as nitroglycerine and GTN) *Dose under the TONGUE*	600mcg 400mcg	Anginine, Lycinate Tablets Nitrolingual pump spray
Isosorbide Dinitrate	5mg	Isordil tablets

 

 

Note: This medication can reduce blood pressure so it is advisable to be seated prior to taking anginine.

 

How to take this medication

 

• Place half to one tablet of Anginine®/Lycinate® under your tongue (or in the pouch of your cheek) and allow to dissolve; or use one spray of Nitrolingual Spray® under your tongue.

 

• If after 5 minutes the pain is not relieved, place another tablet or spray under the tongue. If the pain continues after using up to 3 tablets or sprays within 15 minutes, CALL 000 (in Australia) FOR AN AMBULANCE.

 

• After angina has been relieved, you may spit out or swallow what is left of the tablet to avoid adverse effects such as headache.

 

• ALWAYS REMEMBER to write the date you open your bottle of Anginine®/Lycinate® tablets on the bottle. Discard any remaining tablets after 3 months and obtain a fresh supply.

 

• Store your Anginine®/Lycinate® in a glass bottle. Never carry loose tablets in your pocket, as they may not remain effective.

 

Anginine®/Lycinate® is also available over the counter from your community pharmacy.

 

LONG-ACTING NITRATES 

 

 

Generic name	Strength	Brand name®
Isosorbide Mononitrate tablets	60mg	Arsorb, Duride, Imtrate SR Imdur, Isomonit, Monodur
Glyceryl Trinitrate Patches	5mg/24 hrs 10mg/24 hrs	Nitro-Dur 5, 10, 15mg Minitran 5, 10, 15mg Transiderm Nitro 25 Transiderm Nitro 50

 

 

How to take this medication

• Use regularly to prevent angina attacks. Take tablets at the time of day when angina is most frequent, e.g. at night for nocturnal angina or in the morning for daytime angina.

 

• Do not crush or chew tablets.

 

• Do not cut Imtrate® in half, as there is insufficient evidence to show that a halved tablet delivers half the dose of one full tablet (the other products may be halved).

 

• Apply the patches to the chest (best place) or anywhere above the knees or elbows. Avoid hairy areas because the patches do not stick well. Put your patch on a new position each day to prevent skin irritation.

 

• Do not leave the patch on all the time. Usually patches are applied for no more than 12 hours per 24-hour day. Otherwise the body becomes tolerant to the medication and it doesn't work as well.

 

• Always consult your doctor before starting other medication. Some medications (e.g. Viagra) may have severe interactions with nitrates.

 

Side effects and adverse reactions

 

Headaches (usually last 1-2 weeks after starting treatment). Using a pain reliever such as paracetamol can be effective.

 

Light-headedness, dizziness. If affected, get up slowly from your chair or bed. Do not operate dangerous machinery or drive a car until you know how this medicine affects you.

 

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This information was first published in You and Your Heart - an education booklet for patients, families and friends. © 2006 Northern Sydney Central Coast Area Health Service