5 Diabetes Drugs that Increase Heart Failure Risk

• Thiazolidinediones (TZDs), such as rosiglitazone (Avandia) and pioglitazone (Actos). TZDs work by increasing the body’s sensitivity to insulin, but they can also cause fluid retention and weight gain, which can increase the risk of heart failure.
• Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as saxagliptin (Onglyza), alogliptin (Nesina), and sitagliptin (Januvia). DPP-4 inhibitors work by blocking the breakdown of a hormone that stimulates insulin production, but they have been linked to a small increased risk of heart failure.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as dapagliflozin (Farxiga) and empagliflozin (Jardiance). SGLT2 inhibitors work by blocking the absorption of glucose from the kidneys, but they can also cause dehydration, which can increase the risk of heart failure in people with underlying heart disease.
• Insulin. Insulin is a hormone that helps the body use glucose for energy. However, in people with heart failure, insulin can sometimes make the heart work harder. This can lead to a worsening of heart failure symptoms.
• Metformin. Metformin is a commonly prescribed diabetes drug that works by reducing the amount of glucose that the liver produces. Metformin is generally considered safe for people with heart failure, but it can sometimes cause a rare side effect called lactic acidosis, which can be fatal.

It is important to note that not everyone taking these drugs will develop heart failure. The risk of heart failure is increased in people who have other risk factors for heart disease, such as high blood pressure, high cholesterol, and smoking. If you are taking any of these drugs and you have concerns about your heart health, talk to your doctor.

Here are some diabetes drugs that are considered safe in heart failure:

• Biguanides, such as metformin (Glucophage). Biguanides work by reducing the amount of glucose that the liver produces. They are generally considered safe for people with heart failure.
• Sulfonylureas, such as glipizide (Glucotrol) and glyburide (Diabeta). Sulfonylureas work by stimulating the pancreas to produce more insulin. They are generally considered safe for people with heart failure, but they can sometimes cause low blood sugar levels.
• Meglitinides, such as repaglinide (Prandin) and nateglinide (Starlix). Meglitinides work by stimulating the pancreas to produce more insulin. They are generally considered safe for people with heart failure, but they can sometimes cause low blood sugar levels.

If you have heart failure, it is important to work with your doctor to find the right diabetes medication for you. There are many safe and effective options available.