Drugs for the Treatment of Chronic Heart Failure with Reduced EF | ||
INITIATING DOSE | MAXIMAL DOSE | |
---|---|---|
Diuretics | ||
Furosemide | 20-40 mg qd or bid | 240 mg/d |
Torsemide | 10-20 mg qd or bid | 100 mg/d |
Bumetanide | 0.5-1.0 mg qd or bid | 5 mg/d |
Hydrochlorothiazide | 25 mg qd | 100 mg/d |
Metolazone | 2.5-5.0 mg qd or bid | 20 mg/d |
Angiotensin-converting enzyme inhibitors | ||
Captopril | 6.25 mg tid | 50 mg tid |
Enalapril | 2.5 mg bid | 10-20 mg bid |
Lisinopril | 2.5-5.0 mg qd | 20-40 mg qd |
Ramipril | 1.25-2.5 mg bid | 2.5-5 mg bid |
Trandolapril | 0.5 mg qd | 4 mg qd |
Angiotensin receptor blockers | ||
Valsartan | 40 mg bid | 160 mg bid |
Candesartan | 4 mg qd | 32 mg qd |
Losartan | 25-50 mg qd | 150 mg qd |
Angiotensin receptor-neprilysin inhibitor | ||
Valsartan/sacubitril | 24/26-49/51 mg bid | 97/103 mg bid |
β-receptor blockers | ||
Carvedilol | 3.125 mg bid | 25-50 mg bid |
Bisoprolol | 1.25 mg qd | 10 mg qd |
Metoprolol succinate | 12.5-25 mg qd | 200 mg qd |
Aldosterone antagonists | ||
Spironolactone | 12.5-25 mg qd | 25-50 mg qd |
Eplerenone | 25 mg qd | 50 mg qd |
Additional therapies | ||
Combination of hydralazine/isosorbide dinitrate | 10-25 mg/10 mg tid | 75 mg/40 mg tid |
Fixed dose of hydralazine/isosorbide dinitrate | 37.5 mg/20 mg tid | 75 mg/40 mg tid |
Digoxin | 0.125 mg qd | Guided by renal function and serum level |
Ivabradine | 2.5-5.0 mg bid | 7.5 mg bid |