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Your Heart and the Big Four Medication Types to Avoid

Cleveland Clinic

Allergies coming on? Pain got you down? Before taking any medication to remedy the situation, always read the label, follow directions and consider the side effects.

Discuss all medication and supplement choices with your cardiologist.

For people with heart issues, it’s especially important to know the risk factors of taking certain medications. If you are a heart patient, be sure to discuss all medication and supplement choices with your cardiologist first.

Here are four common medication categories that have heart risk factors.

1. Over-the-Counter (OTC) Pain Relievers

There are two main types of OTC pain relievers: acetaminophen (e.g., Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs include ibuprofen (Advil®, Motrin®) and naproxen sodium (Aleve®). NSAIDs (especially at high doses) can increase your blood pressure and increase your risk for a heart attack or stroke.

If you take prescription drugs to treat your high blood pressure or have heart disease, you should talk to your doctor to find an OTC pain medication that is safe for you.

2. Decongestants

Many OTC cold, flu and allergy medications include decongestants, which can cause a rise in blood pressure and/or interfere with the effectiveness of some prescriptions. Do not take decongestants if you have high blood pressure or are taking medications that treat high blood pressure or heart conditions. An example of a common decongestant is pseudoephedrine (Sudafed®).

3. Certain Antibiotics

Azithromycin is an antibiotic that is commonly used to treat bacterial infections. It is sold under the name of Zithromax® and Zmax® and is commonly called a Z-Pak®.

A recent study found that azithromycin may cause changes in the electrical system of the heart, which can lead to arrhythmia or a rapid heartbeat. Patients at particular risk for developing this condition include those with known risk factors such as existing QT interval prolongation, low blood levels of potassium or magnesium, a slower than normal heart rate, or use of certain drugs used to treat abnormal heart rhythms, or arrhythmias.

The Federal Drug Administration reports that other antibiotics in the same class as azithromycin, called macrolide antibiotics, have similar side effects. It would be advisable to discuss any concerns about macrolide antibiotics with your cardiologist.

4. Herbal Supplements/Medicines

While herbal supplements may seem natural and therefore harmless, think again. Unlike conventional medications, herbal supplements do not undergo rigorous scientific study or approval by the FDA, and serious, even fatal, interactions have been reported between cardiac medicines and some supplements.

Some herbs may even cause heart and vascular problems; they can affect your blood pressure and heart rate whether or not you are taking any heart medications. Therefore, you should always talk to your doctor before taking an herbal supplement.

What to do before taking a new medication or supplement

  • When looking at the label of OTC medications, be sure to read the active and inactive ingredient lists. Many drugs are high in sodium, which raises blood pressure.
  • Use your pharmacist as a resource. He or she can tell you if the OTC medications are not compatible with certain medical conditions and/or your current drug therapy. In addition, they may be able to offer you alternative choices.
  • Most importantly, if you are a heart patient, be sure to discuss all medication and supplement choices with your cardiologist before taking anything.
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