Drugs that can directly harm the heart include anthracyclines used to treat breast cancer and TNF-a inhibitors used to treat rheumatologic diseases. Doctors are aware of these and do everything they can to modify the risk of developing heart failure. Nevertheless, it can happen. Over-the-counter (OTC) drugs arent necessarily harmless, either. Diet pills, decongestants and bodybuilding drugs can contain amphetamines and epinephrine-stimulants known to cause heart failure. Sodium bicarbonate-based antacids can cause sodium and water retention, aggravating heart failure symptoms.