By: Steven Nissen, MD
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Allergies coming on? Pain got you down? Before taking any medication to remedy the situation, always read the label, follow directions and consider the side effects.
For people with heart issues, it’s especially important to know the risks of taking certain medications. If you are a heart patient, be sure to discuss all medication and supplement choices with your cardiologist first.
Here are four common medication categories that you should know about.
1. Over-the-counter (OTC) pain relievers
There are two main types of OTC pain relievers: acetaminophen (e.g., Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs include ibuprofen (Advil®, Motrin®) and naproxen sodium (Aleve®).
Researchers have studied the effect of NSAIDs on people’s hearts, particularly their blood pressure and risk for heart attack and stroke.
In a 2016 study, Cleveland Clinic researchers found that prescription doses of widely used pain-relieving drugs demonstrated no greater heart risk for celecoxib (Celebrex®) than naproxen (Naprosyn®) or ibuprofen (Motrin®).
If you take prescription drugs to treat your high blood pressure or have heart disease, be sure to ask your doctor about the OTC pain medication that is best for you.
Many OTC cold, flu and allergy medications include decongestants, which can cause a rise in blood pressure and/or interfere with the effectiveness of some prescriptions.
However, nasal sprays and oral medications don’t pose the same risks. A nasal spray is a safer choice if you have high blood pressure or you’re taking medications that treat high blood pressure or heart conditions.
Also, be aware that cold and sinus medications may contain combinations of NSAIDS and decongestants.
3. Certain antibiotics
Azithromycin is an antibiotic that is commonly used to treat bacterial infections. It is sold under the name of Zithromax® and Zmax® and is commonly called a Z-Pak®.
A 2012 study found that in rare cases, azithromycin may cause changes in the electrical system of the heart, which can lead to arrhythmia or a rapid heartbeat. Other antibiotics in the same class as azithromycin, called macrolide antibiotics, have similar side effects.
However, it’s important to note that these side effects are extremely rare.
If your doctor prescribes antibiotics, the possibility of side effects should be noted but should not stop you from receiving needed treatment. Be sure to discuss any concerns about macrolide antibiotics with your cardiologist.
4. Herbal supplements/medicines
While herbal supplements may seem natural and therefore harmless, think again. Unlike conventional medications, herbal supplements do not undergo rigorous scientific study or approval by the Food and Drug Administration (FDA), and serious, even fatal, interactions have been reported between cardiac medicines and some supplements.
Some herbs may even cause heart and vascular problems; they can affect your blood pressure and heart rate whether or not you are taking any heart medications. Therefore, you should always talk to your doctor before taking an herbal supplement.
What to do before taking a new medication or supplement
- When looking at the label of OTC medications, be sure to read the active and inactive ingredient lists. Many drugs are high in sodium, which raises blood pressure.
- Use your pharmacist as a resource. He or she can tell you if the OTC medications are not compatible with certain medical conditions and/or your current drug therapy. In addition, he or she may be able to offer you alternative choices.
- Most importantly, if you are a heart patient, be sure to discuss all medication and supplement choices with your cardiologist before taking anything.