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Chest pain
Worsening shortness of breath
Fast or irregular heartbeat
Fainting
Belly pain
Numbness, tingling, pain, or weakness in the hands or feet
Some side effects may go away as your body gets used to the medication. However, if you develop any of the serious side effects listed above, contact your health care provider right away.
Side effects of nitrates may include:
Headache
Feeling dizzy
Skin rash if using a topical patch
Flushing of the face and neck
What Should I Remember While Taking Vasodilators?
Tell your health care provider or pharmacist of any other prescription and non-prescription medications you are taking, including vitamins and herbal supplements.
To prevent feeling dizzy, stand up slowly from sitting or lying positions.
If you develop a headache, you can take Tylenol. Do not take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) or naproxen sodium (Aleve®).
If you develop a severe headache or a headache that does not get better, talk to your health care provider right away.
Do not take sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) with nitroglycerin, as this can cause a dangerous decrease in blood pressure.
Talk to your health care provider if you are pregnant, planning on getting pregnant, or breastfeeding.
What Should I Do If I Miss a Dose?
For oral doses: Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed. Take the next dose at the regular time. Do not take two doses at the same time. If you are unsure of what to do, speak to your health care provider or pharmacist.
For the patch: Apply the patch as soon as you remember and then take it off at the regular time.
DIGOXIN (LANOXIN®)
How Does Digoxin Work?
Digoxin improves the symptoms of heart failure by strengthening the heart’s pumping function. Digoxin can also slow the heartbeat down, so it can be helpful in people with atrial fibrillation.
How Should I Take Digoxin?
Take this medication at the same time each day. Wait two hours after consuming antacids, high-fiber foods, or fiber supplements to take this medication.
What are the Common Side Effects?
Dizziness
Headache
Fatigue
Belly pain
Severe side effects may include:
Loss of appetite
Nausea or vomiting
Blurred or coloured vision, or halos around bright objects
Confusion or weakness
Abnormal heart rhythm, which may cause palpitations or black outs
Seizures
Call your health care provider immediately if you develop any of these side effects, as they may be a sign that there is too much digoxin in your body.
What Should I Remember While Taking Digoxin?
Use with caution if you have certain types of kidney problems. Check with your health care provider first.
Tell your health care provider or pharmacist of any other prescription and non-prescription medications you are taking, including vitamins and herbal supplements.
If you develop another illness and are not able to eat or drink, or if you have a lot of vomiting or diarrhea, contact your health care provider or pharmacist. A blood test may be needed to check the level of digoxin in your blood.
Talk to your health care provider if you are pregnant, planning on getting pregnant, or breastfeeding.
POTASSIUM SUPPLEMENTS
Potassium helps maintain a normal heart rhythm and build muscle, as well as supports overall nutrition. Diuretics used in the treatment of heart failure can lower blood potassium levels, impacting these functions. If the blood potassium level is too low, your health care provider may prescribe potassium supplements.
Medications in this class include:
Potassium chloride tablets (Slow-K®, Euro-K® (previously known as K-Dur®), Apo-K®, Micro-K®)
Potassium chloride dissolvable powder (K-lyte®)
Potassium chloride liquid
How Do Potassium Supplements Work?
Potassium supplements are used to increase the blood potassium level. Maintaining a normal blood potassium level is important in preventing abnormal heart rhythms.
When and How Should I Take Potassium Supplements?
Potassium supplements come in a variety of different forms, such as tablets, liquid, or powder. Take the potassium supplement with a meal or right after a meal to prevent an upset stomach.
What are the Common Side Effects?
Nausea
Upset stomach
Vomiting
Diarrhea
Serious side effects may include:
Sensation of an abnormal heart rhythm
Confusion
Fatigue
Legs that feel heavy and weak
Unusual tingling, prickling, pulling, or burning in your arms, hands, legs, or feet
Belly pain.
If you develop any of the listed serious side effects, talk to your health care provider right away.
What Should I Remember While Taking Potassium Supplements
You may require regular blood tests to monitor your potassium level. Depending on the potassium level, your health care provider may change your dose of potassium supplement.
Tell your health care provider or pharmacist of any other prescription and non-prescription medications you are taking, including vitamins/minerals and herbal supplements.
It may be recommended that you speak with a dietician to discuss how often you eat foods that are good sources of potassium (such as spinach, bananas, and tomatoes).
Tell your health care provider if you are taking salt substitutes as they may also contain potassium.
INTRAVENOUS IRON
Intravenous Iron
There is increasing evidence of the benefits of intravenous iron in heart failure patients with low iron levels, including increased energy levels. Effects are typically seen in the first few weeks after the iron infusion. The same effect has not been seen with iron in pill form.
What Causes Iron Deficiency?
There are many different causes of iron deficiency in patients with heart failure. The exact cause in an individual patient is often difficult to determine.
Patients with heart failure may not be taking enough iron in their diet (or even if they are, they may not be able to absorb it properly). They may also have impaired kidney function, which contributes to low iron levels in the body.
Bleeding (especially in the gut) is another important cause, so your doctor may request a colonoscopy if you haven’t had one in the recent past.