Heart Medications Archive


Strategies for taking medications

Doctors may prescribe medications in hopes of helping a patient, but statistics show that at least half of all patients do not follow through with the treatment. Dr. Robert Schmerling explains why some people are choosing to skip taking medications and the possible results of not taking them.

Coping with statin side effects

Some people experience muscle aches or muscle cramps, but trying these tips may help.

About 10% to 20% of inidividuals who take statins report that they experience muscle pain or muscle cramps. 
Image: rogerashford/Thinkstock

Statins, such as atorvastatin (Lipitor), simvastatin (Zocor), rosuvastatin (Crestor), and lovastatin (Mevacor), are commonly prescribed medications that lower "bad" LDL cholesterol and have been shown to help reduce the risk of heart attack, stroke, and death.

Atrial fibrillation: The latest treatment trends

About one in six strokes can be traced to atrial fibrillation. Doctors now have newer and better options to lessen this risk.

Close to one in 10 people ages 65 or older have atrial fibrillation (afib), the most common heart rhythm disorder. During a bout of afib, the usually rhythmic contractions of the heart's upper chambers (the atria) are replaced by an ineffectual quiver. While the symptoms, which include a racing heartbeat, dizziness, and shortness of breath, are troublesome for some people, the real threat lies in the increased risk of stroke that accompanies the condition.

When the heart takes on the afib rhythm, blood does not completely move out of the atria. Instead, it tends to pool and clot in a pouchlike extension in the upper left quadrant of the heart, called the left atrial appendage. If these clots break loose, they may travel to the brain and cause a blockage. This is known as an ischemic stroke.

Muscle problems caused by statins: Can a genetic test reveal your risk?

A mail-order saliva test marketed to consumers may make some promises it can't deliver.

A new mail-order genetic test called StatinSmart bills itself as the first test to identify a person's risk of experiencing muscle pain from a statin. That sounds like potentially helpful information, given that up to half of people who are prescribed statins quit taking them because of perceived side effects—most often muscle pain. Others avoid statins altogether because of that worry.

But here's the rub: muscle problems can range from mild to serious, and the terms experts use to describe them can be confusing. The StatinSmart website says 29% of people who take a statin develop "statin-induced myopathy," which they define as muscle aches, pains, weakness, or cramps.

Why you may need a statin

Although risk calculators disagree, at some point age becomes the deciding factor in the decision to take a cholesterol-lowering medication.

Image: Thinkstock

If you've been diligent about monitoring your risk factors for developing heart disease, you may have realized that online calculators can be helpful. If you have the results from your latest cholesterol test, these online calculators can compute your chance of having a heart attack or stroke in the next decade:

However, each may give you a slightly different number. And while the Framingham calculator might indicate that your risk is low and therefore you don't need a cholesterol-lowering statin drug, the ACC/AHA calculator could indicate that you should be taking a statin to reduce your risk.

Lightheaded? Top 5 reasons you might feel woozy

Lightheadedness is a feeling of wooziness or faintness. It is commonly caused by dehydration, drug side effects, blood pressure drops, low blood sugar, heart disease, or stroke.

Ask the doctor: Medications that affect warfarin

Ask the doctor

Q. I'm helping my mother, who is in her late 80s, keep track of her medications, as she can be a little forgetful. Her doctor just started her on warfarin, which I've heard can interact with many different medications. What are the most common ones?

A. Warfarin (Coumadin), a widely prescribed clot-preventing drug, can be affected by many medications, but antibiotics and related drugs are the most common source of problems. One example is the antibiotic that contains sulfamethoxazole and trimethoprim (Bactrim), which is often used to treat urinary tract infections and bronchitis. It interferes directly with warfarin, heightening its anti-clotting effects, which increases the risk of dangerous bleeding.

Antidote for blood thinner's side effect

There's encouraging news for people who take dabigatran (Pradaxa), a newer type of blood thinner that's had a rare side effect of uncontrolled bleeding during surgery or accidents. In October 2015, the FDA approved an antidote called idarucizumab (Praxbind), which may be able to reverse dabigatran's blood-thinning effects.

Dabigatran was approved by the FDA in 2010 and welcomed as a convenient alternative to warfarin (Coumadin) for people with certain types of atrial fibrillation, deep-vein thrombosis, or pulmonary embolism. While warfarin is generally safe and inexpensive, it takes about a week for it to become effective, and dosing is so complicated that people taking warfarin need frequent blood tests to see if the dose needs to be adjusted. Dabigatran is effective within two hours and doesn't require dose adjustment or lab monitoring. But dabigatran has caused more episodes of major bleeding than had been expected, without a way to reverse the problem.

Once-a-day blood pressure medication

Ask the doctor

Q. I take my blood pressure medication twice a day. Or at least I am supposed to, but I sometimes forget the second dose because my evenings tend to be really busy. What can I do?

A. One idea is to leave a sticky note on your bathroom mirror or near your bed as a reminder. Or try using an alarm (either a traditional alarm clock or one on a smartphone) that rings close to the time when you normally go to bed. You might also consider taking the second dose with dinner, assuming your doctor or pharmacist says it is okay to take your particular medicine with food.

FDA approves antidote to anti-clotting drug

Research we're watching

For people who take anti-clotting drugs such as dabigatran (Pradaxa), one serious downside has been the rare but dangerous risk of uncontrolled bleeding in the event of an accident or urgently needed surgery. But in October, the FDA approved idarucizumab (Praxbind), a drug that quickly reverses the effects of dabigatran. Given by injection into a vein, the drug binds to dabigatran and neutralizes its effect, allowing the blood to clot normally.

Dabigatran was approved in 2010 to prevent strokes (most of which are caused by blood clots in the brain) in people with atrial fibrillation. It's also prescribed to prevent and treat venous thromboembolism. Because idarucizumab works specifically on dabigatran, it can't be used as an antidote for similar anti-clotting medications, which include rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa). However, an antidote that works on these drugs is under development, with approval expected within the next year or so.

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