Myocardial Infarction (MI)-Medicine Information

What is a myocardial infarction?

A myocardial infarction, or “heart attack,” occurs when one or more blood vessels that supply the heart become blocked. This may cause the heart muscle to become damaged. Below are some of the medications you may start after a heart attack. 

Cholesterol-Lowering Medications (examples: rosuvastatin, atorvastatin, simvastatin)

High cholesterol can cause blockages within the blood vessels of your heart. After a heart attack, it is recommended to start a statin therapy, which can lower the risk of another heart attack.

  • Possible side effects:  Nausea, muscle weakness, rash

  • How to take:  Take simvastatin, fluvastatin, and lovastatin at nighttime.  All others may be taken at any time of day. 

Beta-blockers (examples: metoprolol, atenolol, carvedilol)

These medicines can help reduce heart rate and blood pressure, as well as reduce the work that the heart has to do. This is important for hearts that are recovering from a heart attack.  Beta blockers may also be helpful in reducing chest pain, or "angina."

  • Possible side  effects: Fatigue, low blood pressure, dizziness, feeling  lightheaded

  • How to take: Take carvedilol (Coreg) with food.  All others may be taken without regards to meals.  

Angiotensin-converting enzyme inhibitors (“ACE inhibitors” examples: lisinopril, Ramipril, fosinopril) or Angiotensin-receptor blockers (“ARBs” examples: losartan, valsartan, olmesartan)

These medicines improve heart function after having a heart attack. They help open up blood vessels and lower blood pressure.

  • Possible side effects: Dry cough, low blood pressure, dizziness

  • How to take:  Take captopril and moexipril on an empty stomach.  All others may be taken without regards to meals. 

Antiplatelet Medications (examples: aspirin, clopidogrel, prasugrel, ticagrelor)

After a heart attack, your doctor will typically place you on one or more anti-platelet medicines. These medicines can prevent platelets in your blood from “sticking” together in your blood vessels or newly placed stent(s).

  • Aspirin is the most common agent used after a heart attack. This medicine is typically found over-the-counter (non-prescription) as a chewable tablet or as an enteric coated (“EC”) tablet. You may be on a daily aspirin for life after your heart attack.

    • Possible side effects:  Nausea, vomiting, increased bruising or bleeding

    • How to take: To avoid stomach upset, it is best to take the aspirin with food.

  • Other antiplatelet medicines include clopidogrel, prasugrel and ticagrelor. These work together with aspirin. It is important to take this medicine every day until told by your doctor to stop.

    • Possible side effects:  Increased bruising or bleeding, rash, nausea

    • How to take: Take with or without food

Nitroglycerin

Nitroglycerin can help to decrease chest pain by opening up the blood vessels to the heart. Nitroglycerin comes in a couple of different forms:

  • Short-acting (for use only in chest pain attacks that are actively occurring)

    • Possible side effects: Low blood pressure, flushing, headache

    • How to take sublingual nitroglycerin:  Place one tablet under the tongue every 5 minutes until chest pain is relieved for maximum of 3 doses in 15 minutes.  Call 9-1-1 if chest pain is unrelieved after first dose.

  • Long-acting (for everyday use to prevent chest pain attacks)

    • Possible side effects: Low blood pressure, flushing, headache

    • How to take:  Do not crush or chew. Imdur and Isordil may be cut in half. Take with a full glass of water

It is important to take these medications exactly as directed, and to avoid certain medications (like Viagra®, Levitra®, or Cialis®) that can cause unsafe blood pressure decreases when used with nitroglycerin.