Heart Failure

Drug	Initial Dose	Target
Angiotensin-Converting Enzyme Inhibitors
Captopril	6.25-12.5 mg q6-8h	50 mg tid
Enalapril	2.5 mg bid	10 mg bid
Fosinopril	5-10 mg daily; can use bid	20 mg daily
Lisinopril	2.5-5.0 mg daily; can use bid	10-20 mg bid
Quinapril	2.5-5.0 mg bid	10 mg bid
Ramipril	1.25-2.5 mg bid	5 mg bid
Trandolapril	0.5-1.0 mg daily	4 mg daily
Angiotensin Receptor Blockers
Valsartan	40 mg bid	160 mg bid
Losartan	25 mg daily; can use bid	25-100 mg daily
Irbesartan	75-150 mg daily	75-300 mg daily
Candesartan	2-16 mg daily	2-32 mg daily
Olmesartan	20 mg daily	20-40 mg daily
Thiazide Diuretics
HCTZ	25-50 mg daily	25-50 mg daily
Metolazone	2.5-5.0 mg daily or bid	10-20 mg total daily
Loop Diuretics
Bumetanide	0.5-1.0 mg daily or bid	10 mg total daily (maximum)
Furosemide	20-40 mg daily or bid	400 mg total daily (maximum)
Torsemide	10-20 mg daily or bid	200 mg total daily (maximum)
Aldosterone Antagonists
Eplerenone	25 mg daily	50 mg daily
Spironolactone	12.5-25.0 mg daily	25 mg daily
β-Blockers
Bisoprolol	1.25 mg daily	10 mg daily
Carvedilol	3.125 mg q12h	25-50 mg q12h
Metoprolol succinate	12.5-25.0 mg daily	200 mg daily
Digoxin	0.125-0.25 mg daily	0.125-0.25 mg daily