Medication for the heart

Patients with heart disease are often prescribed a great number of different tablets to take. For example after a heart attack a person might be put on 5 different drugs (e.g. aspirin, clopidogrel, ramipril, bisoprolol, atorvastatin). This seems like a lot of medication but over the last 30 years each type of medicine has been test in large clinical trials which have shown benefit to people treated with these drugs.

In this section we deal with the common types of medication used in cardiology

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Medication

Anti-platelet Drugs

Aspirin
Clopidogrel
Prasugrel
Tigacrelor
Dipyridamole

There drugs reduce the ability of the platelet in blood to stick to each other and also to the lining of the blood vessels. This increases the time it takes for blood clotting to occur.
These drugs are used to prevent and treat heart attack and stroke and are routinely given after coronary artery stenting. Sometimes a combination of medication is used e.g. aspirin and clopidogrel especially after a coronary stent has been implanted.

Anti-Coagulants

Warfarin
Dabigatran
Rivaroxaban
Apixaban

These drugs reduce the ability of the blood to clot by either blocking the production of clotting factors in the liver (warfarin) or directly blocking the activity of some of the clotting factors (e.g. thrombin or factor Xa).
These drugs are used to prevent clotting of the blood especially in people with rhythm disorders such as atrial fibrillation or flutter, in patients with clots in the veins of the legs or lung or in people with metallic heart valves.
Warfarin has been around for the long time but can be difficult for some people to take as the dose often varies and the effect can be less predictable. The new oral anticoagulant drugs (NOAC) listed have a more predictable effect and do not need to be monitored with blood tests. These drugs are licenced for the treatment of patients with DVT and pulmonary embolism and also atrial fibrillation. They are not suitable at present for people with artificial metallic heart valves.

Beta-blockers

Bisoprolol
Atenolol
Metoprolol
Carvedilol

These drugs are used as treatments for palpitations, angina, heart failure. They were used originally to treat high blood pressure but whilst effective there are better drugs now available.

ACE Inhibitors and ARBs

Rampril
Lisinopril

Losartan
Irbesartan

Nitrates

GTN
Isosorbide mononitrate

Diuretics

Frusemide
Bumetanide

Spironolactone
Amiloride

Statins

Simvastatin
Atorvastatin
Pravastatin

Anti-arrhythmics

Flecanide
Propafenone
Sotalol
Amiodarone
Dronedarone
Mexilitine