Abstract Heart failure (HF) is a chronic debilitating and potentially life-threatening condition. HF patients are usually at high risk of polypharmacy and consequently, potentially inappropriate prescribing leading to poor clinical outcomes. Based on the published literature, a comprehensive HF-specific prescribing review tool is compiled to avoid medications that may cause HF or harm HF patients and to optimize the prescribing practice of HF guideline-directed medical therapies. Recommendations are made in line with the last versions of European Society of Cardiology (ESC) guidelines, ESC position papers, scientific evidence, and experts’ opinions.