Congestive heart failure drugs to avoid

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ACC/AHA Guideline Recommendations Initial and Serial Evaluation of the HF Patient Hospitalized Patient Patients With a Prior MI Sudden Cardiac Death Prevention Surgical/Percutaneous/Transcather Interventional Treatments of HF Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D) Coordinating Care for Patients With Chronic HF Quality Metrics/Performance Measures
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Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF NSTEMI with Heart Failure and Cardiogenic Shock
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Drugs to avoid in CHF include those with a negative inotropic effect.

Drugs to Avoid in CHF

• Dronedarone should be avoided in patients who were hospitalized with CHF (this is a boxed warning)
• Sotalol (has a negative inotropic effect)
• Disopyramide is contraindicated in patients with heart failure
• Calcium channel blockers should generally be avoided unless the patient has diastolic dysfunction

ACC/AHA Guidelines- Antiarrhythmics Recommendation

“

Class I 1. Drugs known to adversely affect the clinical status of patients with current or prior symptoms of heart failure and reduced left ventricular ejection fraction (LVEF) should be avoided or withdrawn whenever possible (e.g., nonsteroidal anti-inflammatory drugs, most antiarrhythmic drugs, and most calcium channel blocking drugs. (Level of Evidence: B)

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