Heart failure
Common side effects of heart failure medication
Most medicines have unwanted effects, but everyone reacts differently, and not everyone is aware of them. Because people with heart failure often take combinations of many different drugs, they may experience unusual sensations or new feelings.
Some reactions such as extreme sun-sensitivity are clearly seen as a side effect of medication, but other effects such as confusion or memory loss may be side effects of heart failure.
Experiences with side effects
One or two people said they experienced no side effects from their medication, and several recognised that it could be difficult to tell the difference between symptoms and side effects.
She cannot separate side effects from her actual heart failure.
She cannot separate side effects from her actual heart failure.
Beth assumed that the burning sensation she felt in her gut after taking medication was a side effect but she later learned it was angina pain.
Beth assumed that the burning sensation she felt in her gut after taking medication was a side effect but she later learned it was angina pain.
So can you describe that feeling then, it’s not exactly a pain?
It's not a pain it’s more a, a discomfort. And the only way I could describe it to the hospital was as if I had swallowed bleach, as if I had swallowed a couple of capfuls of bleach and my insides were burning. And that was the pain I felt when I was having the heart attack as well. But like I said because I’d had it prior, and it always seemed to be after I was taking my medications, I thought it was one of the tablets sticking in my throat and dissolving, but unfortunately it turned out it was cardiac. And when I started getting that pain again more recently, I knew, you know, I need to speak to my doctor about this straight away. And my doctor dealt with it, you know, reassured me that it was angina pain and just to use my spray. And if it become more problematic I had to go back in and see him. Or if it didn’t, if the spray didn’t take the pain away I was to phone 999 and get an ambulance straight away.
A wide range of side effects were reported by people we spoke to: some of which caused them to stop taking a particular medicine and try another one.
Some of the side effects mentioned were due to the medicines having their desired effect, but too strongly.
Dizziness and nausea were common after first starting to take beta-blockers, though these feelings usually stopped once people got used to the drugs.
Some felt that their heart had been slowed too far by beta blockers, making it difficult for them to do all their normal activities.
He describes how his beta-blockers affected him.
He describes how his beta-blockers affected him.
But the water tablets, the morning ones and the heart tablets which now have been regulated now. I used to take them in the mornings but now I'm taking them in the evenings, which I think is a better thing because when you took them in the morning, well I used to have like dizzy spells if I was to bend down too quickly, I'd feel faintish. And then my GP at the hospital turned round and said, 'Well they're changing the programme and putting them on nights because obviously, you're relaxed, your sleeping.' So if your pressure goes down or whatever, you're in sleep, it's not going to kill you so you're there in sleep so not going to feel it, which is better.
Are those the beta-blockers?
The beta-blockers, yes.
Well, it's hard to pin-point because I take 4, 5 in the mornings so I've got 5 tablets working around so I don't know if it's this or that. The only one I have, well obviously the beta-blocker, when I went up from the 1mg to 2.5 and then 3.75, then it went on to 5, oh that was, you know that was when I could feel the heart, you know what I mean?
Because obviously, well the way I look at it, it's slowing it down so if I'm continuing doing what I normally do it's putting extra pressure on my heart so obviously you're going to feel it more, ain't it? Because you've one slowing it down and there's you trying to work it and it's going, hang on, what's going on here, you know. This has said slow down and you're saying you want more, you know what I mean? So, I explained that to the nurses down there and they says, 'Oh, if you feel uncomfortable just drop that down to the one that you feel comfortable with.' Like again, none of the other tablets, nobody said nothing to me about the other tablets, you know what I mean? And it doesn't seem like they're interested about the other tablets, it's just the beta-blocker and that's it.
Peter says beta blockers depress his ability to be active; he sometimes feels light headed because the drugs have lowered his blood pressure.
Peter says beta blockers depress his ability to be active; he sometimes feels light headed because the drugs have lowered his blood pressure.
Other side effects included headache and cold extremities. One man said he experienced hot feet and had to sleep with his feet outside the bed covers or use a cold water bottle to cool them down.
A young man said that spironolactone caused him chest pain, so he was switched to eplerenone.
Anti-platelets/anti-coagulants and side effects
People who were taking anti-platelet drugs or anti-coagulants to thin the blood found that they bruised easily or bled a lot from the slightest injury.
Some people had nose bleeds (see ‘Warfarin, digoxin, aspirin and statins’).
Diuretics and side effects
Diuretics rid the body of excess fluid, so going to the loo is a primary side effect of the medication.
People we spoke with said they had to empty their bladder repeatedly in the hours immediately following taking a diuretic. This was inconvenient and interfered with their activities or their sleep, depending on what time of day they took the medicine.
Those who took the drug in the mornings either delayed going out or had to make sure they knew where the nearest toilet was if they did go out (see ‘Beta blockers, ACE inhibitor, diuretics and aldosterone antagonists’).
Some found this less of an issue after lowering the dose of their diuretic. Altering the timing of the tablets could also help avoid it interfering with trips away from home.
Too high a dose of diuretics could make people dehydrated and several had been advised to keep their fluid intake up despite taking diuretics, but achieving the right fluid balance could be difficult.
As Brian explained, 'On the one hand you’re taking diuretic pills to get rid of water, on the other hand you’ve got to drink a lot of water; slight paradox there'.
She balances her diuretics with her fluid intake and to avoid dehydration.
She balances her diuretics with her fluid intake and to avoid dehydration.
Can you tell me a bit about the diuretics and how you take those?
Well I used to have two every day, two tablets, and I found that I was in a lot of constant you know trots and things and then they cut it down to one because I was getting peculiar side effects and dizziness, and I'd had more kidney blood tests done, and there was an area where the graft didn't show the right figures it should have had and the doctor said to me that I should really be drinking more water. But the fact that I wasn't drinking enough water he said he would try cutting down the diuretic to just one tablet and I've been on one tablet ever since and that seems to be helping.
Diuretics, ACE inhibitors, and the anti-arrhythmic drug amiodarone can affect kidney function. As a result of this effect, one man said his diuretic dose had been halved and a woman had been referred to a specialist for further investigations. For more about reduced kidney function see 'Kidney health'.
ACE inhibitors and side effects
Many people experienced a persistent dry cough when taking certain ACE inhibitors; one woman said that clopidogrelhad made her cough, although this is rare.
Some people said that their doctor had taken them off their ACE inhibitor and prescribed an alternative type of medicine (see also ‘Beta blockers, ACE inhibitor, diuretics and aldosterone antagonists’).
He stopped taking ramipril because he developed an awful cough that kept him awake at night
He stopped taking ramipril because he developed an awful cough that kept him awake at night
Brian says that his GP has carefully monitored his medication, prescribing alternatives to ACE inhibitors.
Brian says that his GP has carefully monitored his medication, prescribing alternatives to ACE inhibitors.
Anne stopped taking an ACE inhibitor because of a cough and was switched to various other medicines in turn, each of which gave her unacceptable side effects.
Anne stopped taking an ACE inhibitor because of a cough and was switched to various other medicines in turn, each of which gave her unacceptable side effects.
Angiotensin Resister Blocker, or something like that.
Blocker, yes, yes, yes. That’s right. And then I was put on to spironolactone or eplerenone and both of them gave me absolute disaster with my gut. I couldn’t go out anywhere without rushing to the loo and so I can’t take either of those drugs which are very useful for extending life apparently. So I don’t take those and I can’t take. When I was changed from the ACE inhibitor my consultant wanted me to take a particular dose of candesartan. So I started taking it and with the nurses I was increasing it and it just made me unbelievably breathless. I couldn’t walk half way down the garden. It was dreadful. So I, I said, ‘I’m not, I’m not going to stick with it. I can’t. It’s just awful’. So they put me on to losartan and I had the same effect, so I am on a tiny, tiny little dose of losartan, although I don’t think my consultant is very pleased with it , the nurses say, ‘Well, you know, everybody is different and that’s all you probably need.’ I’ve never had high blood pressure so, you know, it probably is all I need. So, but it keeps me well.
Side effects on the digestive system were also reported. These included indigestion, nausea, loss of appetite, taste changes, and constipation or diarrhoea.
Many found it difficult to pinpoint the cause of some side effects like a loss of appetite.
One woman found that the smell of food put her off eating, though she still liked cooking.
Another person found that he often hated certain food that he had liked before he was ill, which he blamed on all the drugs he was taking.
She has almost no appetite left.
She has almost no appetite left.
He feels that the amount of medication he's on has affected his appetite and taste.
He feels that the amount of medication he's on has affected his appetite and taste.
Oh, no doubt about it. It's absolutely down to the medication. I mean, if you think about what I said earlier about the quantity of drugs chucking it down in your tummy, it's not all at once, it's some in the early morning and then after breakfast and every meal I have to have Metformin which is to counteract sugar.
See also ‘Other side effects’.
Last reviewed: August 2025.
Last updated: April 2016.
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