Ask an Expert

Medications

Find answers to frequently asked questions about medications, like how they work and possible side effects.

  • What is Multaq?

  • Multaq is the brand name for dronedarone, a drug made by the pharmaceutical company Sanofi-Aventis. It was initially approved in July 2009 to reduce the risk of cardiovascular hospitalization in patients with non-permanent atrial fibrillation or atrial flutter with a recent arrhythmic episode and other cardiovascular risk factors.
  • What are possible side effects of taking statins?

  • Although statins are generally well-tolerated among patients, common side effects include muscle and joint aches, nausea, diarrhea and constipation. Less common, serious side effects include liver damage and muscle problems.
  • What does "medication adherence" mean?

  • Medication adherence means taking the proper dose of a drug the correct number of times each day and never adjusting or skipping doses without being advised to do so by a physician. Failing to properly adhere to medications could render drugs ineffective or actually harm the body.
  • What aspirin dose is prescribed for patients with history of heart attack and stroke?

  • Patients with a history of cardiovascular events are typically prescribed 75–300 mg/day of aspirin to help reduce their risk for heart attack and stroke.
  • Why are patients receiving valve replacement reliant on blood thinners?

  • Most valve replacement patients need to be on lifelong anticoagulation therapy because their surgery puts them at increased risk for blood clots. The body is more likely to create blood clots on or around a foreign object like a replacement valve. If a blood clot forms, breaks off and travels to the heart, it can get stuck in a vein or artery and block the flow of blood, causing a heart attack or stroke. Therefore, taking blood thinners helps prevent the formation of blood clots and decreases risk for heart attack and stroke.
  • Who should take statins?

  • Statins are commonly prescribed to patients with high cholesterol. Most often, patients who need to lower their LDL cholesterol the most are prescribed stronger doses of statins, while those needing to lower their cholesterol slightly may be prescribed lower doses.
  • Who needs statins?

  • Statins are often prescribed to patients with high LDL (“bad”) cholesterol, who are at increased risk for heart disease. Statins help eliminate bad cholesterol from the body and reduce cardiovascular risk.
  • What medications are typically used to prevent a first heart attack?

  • A variety of medications exist that can help high risk patients reduce their heart attack risk. Blood thinning medications, such as aspirin, can help make the blood less sticky, lowering risk for a blood clot. Beta blockers can help lower heart rate and blood pressure and cholesterol-lowering medications, such as statins, can help lower cholesterol and keep the arteries clear. Lifestyle changes are also key, including quitting smoking (if a smoker), maintaining a healthy weight, eating a healthy diet, exercising regularly and managing stress.
  • What should I do if I have side effects from high-dose simvastatin?

  • If you are experiencing muscle pain, tenderness, weakness, tiredness, or dark or red colored urine, call your doctor immediately. These are signs of possible muscle injury and should be discussed with your healthcare provider.
  • How do anti-clot medications work?

  • Anticoagulants, or anti-clot medications, such as heparin and warfarin, prevent the production of certain proteins needed for blood to clot. As a result, they can help keep existing blood clots from getting larger and prevent new ones from forming.
  • How do statins work?

  • Statins are cholesterol-lowering drugs that help prevent the build-up of plaque in the arteries. Combined with healthy lifestyle choices like eating a healthy diet and exercising regularly, statins can be extremely effective in reducing risk for heart disease, heart attack and stroke.

  • How can patients help improve medication adherence on their own?

  • Patients can help improve adherence by understanding how their medications work, taking their medications at the same time(s) each day, using notes or alarms as reminders to take medications, and allowing family or friends to help support them.
  • Are there any negative side effects of cytisine?

  • In the study published in the New England Journal of Medicine, researchers found that increased risk for gastrointestinal adverse events might be associated with the drug. However, further research is needed to better assess this relationship.
  • Are there differences among different types of statins?

  • Yes. Statins can differ in many ways, including efficacy, side effects and drug interactions. The type of statin that is right for a patient depends on his or her unique needs, as determined by a health care provider.
  • Can I control my blood pressure without medication?

  • You can help reduce or control your blood pressure through healthy lifestyle changes—maintaining a healthy weight, eating a heart-healthy diet and exercising regularly. Also, for smokers, quitting smoking can help drastically improve blood pressure and reduce cardiovascular risk. However, for some patients, making these changes may not be enough to properly control blood pressure and medication may be necessary.
  • Are statins always used in patients with high cholesterol?

  • Although statins are extremely effective in lowering cholesterol and reducing cardiovascular risk, not all patients may need them. In fact, cholesterol can be effectively lowered in some patients with simple lifestyle changes including exercise and diet.
  • Is a statin right for me?

  • A statin should be used when the benefits outweigh the risks. Therefore, the decision should be based in risk assessment.  We know that patients who have had a previous heart attack or stroke are at high risk for another, so these patients should generally be on a statin.  In patients who have not had a heart attack or stroke, but are at increased risk for these conditions, the decision to use a statin requires a careful assessment of risks.  Given that statins have a very low risk of major side effects, for many patients, the risk-benefit equation will be in favor of treatment.  Ways to assess risk include what we call “traditional risk factors,” which include basic clinical factors like age, gender, blood pressure, smoking, and cholesterol.  Occasionally, the imaging of plaque (e.g., coronary artery calcium scan or carotid ultrasound) can be helpful to more accurately determine a patient’s risk. While the best method of determining risk is evolving, physicians in the United States follow guidelines that currently link recommendations to cardiovascular risk assessment by calculation of a person’s 10-year risk of a fatal or nonfatal heart attack.
  • Should I stop taking Multaq for non-permanent arrythmia?

  • If you are currently taking Multaq, do not stop taking this drug without consulting with your physician. Any side effects should be reported to the FDA MedWatch Program, and all questions or concerns should be discussed with your healthcare provider.
  • Should the use of simvastatin be avoided altogether?
  • The FDA has revised guidelines to limit the use of high-dose simvastatin only in patients to reduce risk for muscle injury. This amendment was based on research showing a relatively high risk for myopathy associated with high-dose simvastatin in comparison with low-dose simvastatin (very low risk). Therefore, the FDA does not recommend restricting the use of simvastatin all together — only high-dose simvastatin in new patients or those recently prescribed with the drug.
  • How does cytisine work to aid smoking cessation?

  • Cytisine is a type of drug that is a nicotine substitute made from a type of seeds, called laburnum seeds. By imitating the effects that smokers get from nicotine, taking cytisine can help cut cravings and wean smokers off of cigarettes.
  • How does aspirin help prevent heart attack and stroke?

  • Aspirin helps prevent heart attack and stroke by reducing blood clotting. Although blood clotting is the body’s natural way of healing damaged blood vessels, blood clots can travel to the heart and block major arteries, causing heart attack or stroke. Therefore, those at high risk for heart attack and stroke often take aspirin to help reduce clotting and risk for future cardiac events.
  • I have tried many medications for angina but I continue to have symptoms. Is there a role for ranolizine? Other therapies?
  • Are there any medications that I should stop taking after being diagnosed with aortic stenosis?
  • Are there medications that I should take to lower my risk of developing atherosclerosis?
  • For how long should I take a blood thinner such as coumadin?

Ask an Expert

Please note that every question submitted will not receive a direct response from a Cardiologist. However, we will follow-up with suggested ways to find appropriate information related to your question. Please do not use your last name or any other confidential information in your question.

Meet our Expert

Your questions are answered by more than two dozen members of the American College of Cardiology who volunteer their time with CardioSmart.

Learn more about our volunteers