title: Polypharmacy in heart failure: drugs to use and avoid.
abstract: Polypharmacy, the use of 4 or more medications, is universal in patients with heart failure (HF). Evidence-based combination therapy is prescribed in patients with HF with reduced ejection fraction (HFrEF). Additionally, treatment of the high prevalence of comorbidities presents many therapeutic dilemmas. The use of nonprescription medications is common, adding further complexity to the medication therapy regimens of patients with HF. An approach for combining evidence-based therapies in patients with HFrEF is presented. Strategies for optimizing the management of common comorbidities in patients with HF are reviewed. Both prescription and nonprescription medications to avoid or use with caution are highlighted.
authors.affiliation: Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA.
authors.forename: Brent N
authors.initials: BN
authors.lastname: Reed
authors.affiliation: Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA.
authors.forename: Jo E
authors.initials: JE
authors.lastname: Rodgers
authors.affiliation: UNC Center for Heart and Vascular Care, University of North Carolina at Chapel Hill, 160 Dental Circle, Chapel Hill, NC 27599, USA. Electronic address: carla_sueta@med.unc.edu.
authors.forename: Carla A
authors.initials: CA
authors.lastname: Sueta
mesh_terms: D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D004366:Nonprescription Drugs / Q000627:therapeutic use; D019338:Polypharmacy; D017410:Practice Guidelines as Topic
chemical_list: D004366:Nonprescription Drugs
keywords: Comorbidities; Heart failure; Polypharmacy