Managing Your Medications Safely

When you are discharged, you will receive a new prescription for all of your medications. Only take the medications prescribed at your discharge from the Heart Institute. Following these steps will help you manage your medications safely:

When you receive the prescription, make sure you ask:

The name of the medication

  • Why it is being prescribed
  • When and how it should be taken
  • How long you will need to take it
  • What side effects you may expect to have
  • What you should do about the side effects

When you pick up your prescription, ask your pharmacist:

  • To explain the best way to take your medication
  • To explain what is written on the labels
  • To provide written information about the medication

TRY TO USE THE SAME PHARMACY FOR ALL OF YOUR PRESCRIPTIONS

It is important for your pharmacist to have a complete list of all of your medications. Your pharmacist can evaluate if your medications can be taken safely together.

CARRY YOUR MEDICATION LIST WITH YOU

Review your list regularly with your doctor or pharmacist. Make sure your list includes:

  • All of your medications, vitamins, supplements, and herbals
  • Your allergies and immunizations
  • Pharmacy phone number

If you have trouble remembering to take your medications, the following tips may be helpful:

  • Take your medication at the same time each day.
  • Associate your medication with daily activities (e.g., mealtimes or brushing your teeth).
  • Use a pill organizer (dosette).
  • Ask your pharmacy if they can organize your pills in blister packs.
  • Keep a one day supply of pills with you.
  • Put a note on your calendar to remind you to pick up your prescription refills.
  • If you miss a dose, check with your pharmacist or doctor before taking an extra dose.
  • Continue to take the medication, even when you feel well.
  • If your medications are finished, this does not mean you should stop taking them. Call your doctor’s office to discuss what should be done with medications.

Do not store medications in hot or humid areas such as the bathroom or glove compartment of your car.

TAKE YOUR MEDICATIONS AS PRESCRIBED BY YOUR DOCTOR

If you have concerns about taking medications, make sure you discuss this with your doctor. If you experience troublesome side effects, your doctor may be able to change your medication.

THE COST OF YOUR PRESCRIPTION

If you are worried about the cost of your prescription, ask to speak to the social worker before you are discharged from the Heart Institute. The social worker can help you determine if you might be eligible for the assistance.

Check with the Ontario Trillium Program for possible assistance:

Medication Information

Listed below are medications commonly prescribed for patients with cardiovascular disease and associated complications. For more detailed information about your specific medications, contact your pharmacist.

Type of Medicine Names of Medication How Medication Works Potential Side Effects
Beta Blockers Acebutolol (Rhotral®, Sectral®)
Atenolol (Tenormin®)
Bisoprolol (Monocor®)
Carvedilol (Coreg®)
Labetalol (Trandate®)
Metoprolol (Betaloc®, Lopressor®)
Nadolol (Corgard®)
Pindolol (Visken®)
Propranolol (Inderal®)
Timolol (Blocadren®)
  • Lowers blood pressure and heart rate
  • Helps prevent angina
  • Improves heart function
  • Slows down irregular heart rhythms
  • Decreases the risk of future
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing
ACE Inhibitors
(Angiotensin Converting Enzyme Inhibitors)		 Benazepril (Lotensin®)
Captopril (Capoten®)
Cilazapril (Inhibace®)
Enalapril (Vasotec®)
Fosinopril (Monopril®)
Lisinopril (Zestril®, Prinivil®)
Perindopril (Coversyl®)
Quinapril (Accupril®)
Ramipril (Altace®)
Trandolapril (Mavik®)
  • Relaxes blood vessels and lowers blood pressure
  • Decreases the risk of future heart attacks
  • Maintains the heart’s shape promoting normal function
  • Cough
  • Dizziness, lightheadedness
  • Increased potassium level in blood
  • Swelling of lips/face/throat (rare) – Call 911
Angiotensin II Receptor Blockers (ARBs) Candesartan (Atacand®)
Irbesartan (Avapro®)
Losartan (Cozaar®)
Olmesartan (Olmetec®)
Telmisartan (Micardis®)
Valsartan (Diovan®)
  • Relaxes blood vessels & lowers blood pressure
  • Decreases the risk of future heart attacks
  • Alternative to ACE inhibitors
  • Dizziness, lightheadedness
  • Headache
  • Increased potassium level in blood
Calcium Channel Blockers Amlodipine (Norvasc®)
Felodipine (Plendil®, Renedil®)
Nifedipine (Adalat XL®)
Diltiazem (Cardizem CD®, Tiazac®)
Verapamil (Isoptin®)
  • Lowers blood pressure
  • Lowers heart rate (diltiazem, verapamil)
  • Helps prevent angina
  • Slows irregular heart rhythms (diltiazem, verapamil)
  • Dizziness, lightheadedness
  • Fatigue/tiredness
  • Headache
  • Swelling of ankles/feet
Narcotics/Analgesics/Pain Relievers Acetaminophen with Codeine and Caffeine (Tylenol 3®)
Hydromorphone (Dilaudid®)
  • Treats moderate to severe pain
  • Reduces the amount of pain experienced
  • Constipation
  • Lightheadedness
  • Drowsiness
  • Nausea, vomiting
Sedatives/Sleeping Pills Oxazepam (Serax® )
Lorazepam (Ativan®)
Tramadol (Ultram®)
  • Helps you to sleep
  • Helps you to relax
  • Dizziness
  • Drowsiness
  • Unsteadiness
Diuretics /Water Pills Ethacrynic Acid (Edecrin®)
Furosemide (Lasix®)
Hydrochlorothiazide (HCTZ, HydroDiuril®)
Metolazone (Zaroxolyn®)
  • Removes excess water by increasing urine production
  • Reduces swelling in legs and ankles
  • Dizziness/lightheadedness
  • Decreased potassium level in blood
  • Gout
Statins Atorvastatin (Lipitor®)
Lovastatin (Mevacor®)
Pravastatin (Pravachol®)
Rosuvastatin (Crestor®)
Simvastatin (Zocor®)
  • Lowers LDL (“bad”) cholesterol
  • Decreases the risk of future heart attacks
  • Constipation, gas
  • Indigestion
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Anti-coagulants Apixaban
Dabigatran (Pradax®)
Rivaroxaban (Xarelto®)
Warfarin (Coumadin®)
  • Helps prevent blood clots from forming or getting bigger
  • Increased risk of bleeding and bruising
Anti-platelets ASA (Aspirin®, ECASA)
Clopidogrel (Plavix®)
Prasugrel (Effient®)
Ticagrelor (Brilinta®)
  • Helps prevent blood clots in injured coronary arteries
  • Helps prevent blood clots on stents (clopidogrel, prasugrel)
  • Decreases the risk of future heart attacks
  • Increased risk of bleeding & bruising
  • Stomach upset (nausea, diarrhea, heartburn)
Anti-arrhythmics Amiodarone (Cordarone®)
Dronedarone (Multaq®)
Sotalol (Sotacor®)
  • Makes the heart beat more regularly
  • Nausea/vomiting
  • Diarrhea
  • Skin may burn more easily under the sun
  • Sun exposed skin may turn bluish grey
  • Thyroid abnormality
  • Decrease in liver function
  • Lung damage (rare)
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing

 

Anticoagulation Medication (Coumadin®)

When taking the anticoagulation medication Coumadin®, following these recommended DOs and DO NOTs will help you manage your medication safely.

THE DOS

  • DO make sure you have regular blood testing (INR) to measure the effectiveness of your Coumadin. You may eat before the blood test.
  • The surgeon’s secretary will call you when they receive your blood test to confirm the dose of Coumadin.
  • If you do not hear from the surgeon’s secretary on the day of your test, DO continue with the same dose of Coumadin and call the surgeon’s office the next day.
  • DO keep a record of your blood test results so that you are aware of the changes and fluctuations.
  • DO take Coumadin at the same time each day: 5:30 p.m.
  • If you miss a dose of Coumadin, please DO call the surgeon’s office the following day.
  • DO ask your surgeon if you should add “Coumadin” to your MedicAlert® bracelet if you need one or already have one.
  • DO contact your doctor if you have extensive bruising, bleeding gums or frequent nosebleeds.
  • DO go to your emergency department if you have a prolonged nosebleed, blood in your urine or brown urine, blood in your bowel movement or a black bowel movement, or bruising and pain in your abdomen.
  • DO tell all of your doctors and pharmacists that you are taking Coumadin.
  • DO eat a normal well-balanced diet.
  • DO ask your surgeon if you should add “Coumadin” to your medical alert bracelet if you need one or already have one.

THE DON’TS

  • DO NOT start or stop taking any other medications, even non-prescription drugs, without permission from your doctor.
  • DO NOT use aspirin or products containing aspirin while taking Coumadin, unless specifically prescribed by your doctor.
  • DO NOT make drastic changes to your diet especially with green vegetables and other foods rich in vitamin K.
  • DO NOT drink more than one ounce of alcohol per day.