A Guide to Common Drugs Prescribed After a Heart Attack (Part 1)

The first heart attack can be an extremely overwhelming and frightening experience. It is not uncommon for people to stay admitted in the hospital for up to 5 days following a heart attack. The goal is to stabilize the individual so that he or she can be safely discharged.¹

Discharge and education

During the discharge period, several prescriptions are routinely prescribed. From my experience as a community pharmacist, most people are prescribed at least 3 medications following a heart attack. Education on these new medications is sometimes provided at the hospital by a nurse, hospital pharmacist, or a physician. Often, patients rely on their retail pharmacist to understand how these medications should be taken.

While most people are provided with drug information sheets on their new prescriptions, they may be too tired or overwhelmed to go through them. The following 2 articles (this is the first) will outline the common medications prescribed after a heart attack and highlight important side effects to note for each class of medications.

What is the goal after a heart attack?

Medications used after a heart attack have two main objectives. The primary objective is to prevent another heart attack; the second is to reduce symptoms such as chest pain. All medications prescribed will focus on targeting one of those two goals.²

Common drugs prescribed

There are several classes of drugs prescribed after a heart attack. These include drug that:²

• Lower cholesterol (statins)
• Reduce blood clot formation (blood thinners)
• Lower blood pressure (antihypertensives)
• Minimize chest pain (nitrates)
• Reduce heart rate (beta blockers)

The statins

Statins are a class of medications that reduce blood cholesterol levels, and therefore plaque formation. Most people who are prescribed statins need to be on the drug lifelong after a heart attack.³

These drugs are taken once daily. Be sure to tell your pharmacist if you consume grapefruit juice on a regular basis as grapefruit juice can interact with some – but not all - of the statins. In addition, tell your doctor immediately if you experience unexplained muscle pain when you start the drug. Your doctor will also order bloodwork for you to ensure that the drug continues to be safe for you.³

Examples of common statins include:³

• Atorvastatin (Lipitor)
• Rosuvastatin (Crestor)
• Pravastatin (Pravachol)
• Simvastatin (Zocor)

The blood thinners

Blood thinners reduce blood clots, and therefore reduce the chance of another heart attack from occurring. These drugs can include an over-the-counter baby aspirin (ASA 81mg) or a prescription medicine. Examples of blood thinners include:⁴

• Clopidogrel (Plavix)
• Ticagrelor (Brilinta)
• Prasugrel (Effient)

Being aware of interactions

The above drugs are typically taken for a limited time, such as 1 year, after a heart attack; however, the aspirin may be used indefinitely. It is important to NEVER discontinue a blood thinner without your cardiologist or general practitioner’s advice – your doctor will inform you when you no longer need to be on the drug.⁵

When on blood thinners, it is important to be aware of other non-prescription and prescription drugs that may interact with these drugs. Your pharmacist will alert you of any interactions with your prescription medications, but they may not be aware of the non-prescription drugs you take. Some over-the-counter drugs to avoid include ibuprofen (Advil) and naproxen, which may increase the risk of bleeding if used along with a blood thinner.⁴

Stay tuned for part 2!

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