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Medications and prevention

Medications to prevent heart disease

In addition to adopting a healthy lifestyle (which includes regular physical activity and a healthy diet), medication is an essential prevention tool, and some medications are routinely prescribed for people with a heart disease.

To thin the blood: Antiplatelet drugs

Medications in this class decrease the risk of a blood clot forming in the arteries.

Aspirin:

Entrophen®
Rivasa®
Novasen®
Asaphen®

  • Enteric-coated tablets to decrease stomach irritation.
  • Take with meals.

Clopidogrel:

Plavix®

Prasugrel:

Effient®

Ticagrelor

Brilinta®

  • Take with or without food.
  • If you have had a dilatation with stent placement, this medication is prescribed for 12 months or more with aspirin.

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To lower cholesterol : Lipid lowering agents

There are many medications to lower cholesterol. The ones most commonly prescribed are called statins.

Class

Name

Indication

Possible side effects

Statins
  • Atorvastatine (LipitorMD)
  • Simvastatine (ZocorMD)
  • Pravastatine (PravacolMD)
  • Lovastatine (MevacorMD)
  • Fluvastatine (LescolMD)
  • Rosuvastatine (CrestorMD)
  • Prescribed to lower bad (LDL) cholesterol
  • Headaches
  • Muscle cramps
  • Fatigue, weakness
Fibrates
  • Fenofibrate (Lipidil SupraMD)
  • Bezafibrate (BezalipMD)
  • Gemfibrozil (LopidMD)
  • Prescribed to lower triglycerides (a type of fat in the blood)
  • Stomach problems
  • Increased liver enzymes
  • Possible drug interactions
Resins
  • Questran (CholestyramineMD)
  • Colesevelam (LodalisMD)
  • Prescribed to lower bad (LDL) cholesterol
  • Constipation
  • Bloating
Nicotinic Acid
  • (Niacine MD)
  • Prescribed mainly to raise good (HDL) cholesterol
  • Hot flashes
  • Itchiness
Medications that prevent the absorption of cholesterol in the intestine
  • Ezetimibe (EzetrolMD)
  • Prescribed to lower bad (LDL) cholesterol

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To decrease the workload of the heart : Beta blockers and ACE inhibitors

Beta blockers :

Metoprolol (LopressorMD)
Atenolol (TenorminMD)
Sotalol (SotacorMD)
Bisoprolol (MonocorMD)
Carvédilol (CoregMD)
Acébutolol (SectralMD)

  • These are the medications most often prescribed in cardiology.
  • They decrease mortality after a heart attack.
  • They decrease heart rate (number of heart beats). The target resting heart rate is 50 to 60 beats per minute.
  • They are very effective but can have many side effects :
    • fatigue;
    • nightmares;
    • impotence;
    • etc.

ACE inhibitors :

Ramipril (AltaceMD)
Quinapril (AccuprilMD)
Perindopril (CoversylMD)
Fisonopril (MonoprilMD)
Cilazapril (InhibaceMD)
Enalapril (VasotecMD)
Trandolapril (MavikMD)

  • These drugs decrease blood pressure by decreasing the arteries' resistance to blood flow.
  • A frequent side effect is a dry cough.
  • You must avoid getting up or changing positions too quickly to avoid becoming dizzy.

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To treat high blood pressure and diabetes

As high blood pressure and diabetes are two major risk factors for coronary artery disease, they must be aggressively treated so as to minimize their harmful impact on heart health. The specific treatment for each condition requires close collaboration with your doctor.

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To treat depression and anxiety

All therapies must also include treatment for stress. If required, your doctor will prescribe anti-anxiety medication, sleep aids or anti-depressants.

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Hormone therapy

Combined hormone therapy (progesterone and estrogen) is not a recognized treatment to protect postmenopausal women against coronary artery disease. This means that hormones may be recommended only to relieve the symptoms of menopause and not to prevent coronary artery disease.

For the treatment to be effective, you must take your medication as prescribed.
Drug treatment must always be combined with a healthy diet and regular physical activity.

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What about over-the-counter drugs ?

In 1995, the Ordre des pharmaciens du Québec created a Drug Caution Code system to indicate precautions for over-the-counter drugs.

When you buy an over-the-counter medication, it is important to check the codes on the label.

What do the codes mean?

The Drug Caution Code is a system made up of 6 letters, each corresponding to a different warning.

General codes
Cautions for everyone
...A...Drownsiness
May cause drownsiness or impair alertness. Avoid alcohol and drugs with a sedative and/or relaxing effect, especially before driving a motor vehicle.
...H...Drug dependency
May cause a drug habit. Must not be taken over a prolonged period.
...X...Talk to your pharmacist
Talk to your pharmacist before taking this product. He or she must explain the specific instructions to be followed when taking this medication.
Personal codes
Consult your pharmacist
...B...Contraindication
May be hazardous to your health if you suffer from hypertension, prostatic hypertrophy, hyperthyroidism (goitre) or if you are taking anti-depressants.
...D...Intolerance
Contains aspirin. Must be avoided if you suffer from gout, stomach ulcers, or asthma or if you are taking an anticoagulant agent (blood thinner).
...E...Diabetes
Not recommended for diabetics. This medication may cause adverse effects.

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