Medications to Treat Heart Failure

A child with cardiomyopathy may take a variety of medication to treat his/her heart failure symptoms. The main categories of drugs include diuretics, inotropics, afterload reducing and beta-blockers.

Diuretics

Known as water pills, diuretics help the body to get rid of excess fluids and sodium through urination. Removing extra body fluid makes it easier for the heart to pump, reduces swelling in the legs and liver, and clears fluid from the lungs to allow the child to breath more easily. Diuretics can be given orally or intravenously and are selected based on the severity of heart failure and the amount of extra fluid in the body.

Medications may include:

  • Furosemide
  • Spironolactone
  • Bumetanide
  • Metolazone
  • Chlorothiazide
  • Hydrochlorothiazide

Common side effects include frequent urination, dehydration and electrolyte abnormalities.

Inotropic Medications

Inotropic medications have many effects and can improve heart function by strengthening heart contractions and improving blood pressure. Most inotropic medications are for short-term use and administered intravenously in the hospital to support children with severe heart failure.

Medications may include:

  • Digoxin
  • Dobutamine
  • Dopamine
  • Epinephrine
  • Norepinephrine
  • Vasopressin

Common side effects include slow heartbeat, vomiting, increased heart rate, arrhythmias, constriction of arteries and low sodium levels.

Afterload Reducing Medications

These medications reduce the work (afterload) of the heart by lowering blood pressure, expanding the arteries and allowing blood to flow more easily to the body. This group of medications includes angiotensin-converting enzyme (ACE) inhibitors, angiotensin I receptor blockers and vasodilators.

Medications may include:

  • Captopril
  • Enalapril
  • Lisinopril
  • Fosinopril
  • Perindopril
  • Ramipril
  • Losartan
  • Milrinone
  • Isosorbide mononitrate
  • Isosorbide dinitrate
  • Nesiritide
  • Hydralazine
  • Nitrates
  • Minoxidil
  • odium nitroprusside

Common side effects include high potassium in the blood, low blood pressure, low white blood cell count, kidney or liver abnormalities, diarrhea, muscle cramps, lightheadedness or dizziness, headache, and increased or irregular heart rate.

Beta-Blockers

Beta-blockers decrease the heart rate and lower blood pressure. By making the heart beat more slowly and with less force, this keeps a weakened heart from overworking. In some cases, beta-blockers help an enlarged heart return to a more normal size.

Medications may include:

  • Atenolol
  • Carvedilol
  • Metoprolol
  • Nadolol
  • Propranolol

Common side effects include dizziness, low heart rate, low blood pressure and fluid retention.

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