| Drug | Initial dosage | Target dosage | Comments | |
|---|---|---|---|---|
| ACE inhibitors | ||||
| Captopril (Capoten) | 6.25 to 12.5 mg three times daily | 50 to 100 mg three times daily | For all ACE inhibitors, start at 50 percent of the initial ACE-inhibitor dosage in patients who have renal insufficiency or are taking moderate to high dosages of diuretics. FDA-approved for heart failure following myocardial infarction | |
| Enalapril (Vasotec) | 5 mg once or twice daily | 10 to 20 mg twice daily | ||
| Fosinopril (Monopril) | 10 mg once daily | 20 to 40 mg once daily | ||
| Lisinopril (Zestril) | 2.5 to 10 mg once daily | 20 mg once daily | ||
| Ramipril (Altace) | 2.5 mg once daily | 5 mg twice daily | ||
| Trandolapril (Mavik) | 1 mg once daily | 4 mg once daily | ||
| Beta blockers | ||||
| Bisoprolol (Zebeta) | 1.25 mg once daily | 10 mg once daily | Not FDA-approved for heart failure | |
| Carvedilol (Coreg) | 3.125 mg twice daily | 25 mg twice daily (50 mg if patient’s weight is > 85 kg [187 lb]) | For all beta blockers, increase dosage every two weeks. | |
| Metoprolol (Toprol XL) | 25 mg once daily (12.5 mg once daily in patients with severe heart failure) | 200 mg once daily | ||
| Metoprolol, immediate release (Lopressor) | 12.5 to 25 mg twice daily (lower dosages in patients with severe heart failure) | 100 mg twice daily | Not FDA-approved for heart failure | |
| Other medications | ||||
| Digoxin | 0.125 to 0.25 mg once daily | Dose to a target serum digoxin concentration of 0.5 to 1.1 ng per mL. | Start at the lower dosage in patients with mild renal insufficiency. | |
| Spironolactone (Aldactone) | 25 mg once daily | 25 to 50 mg every other day or every day | Not FDA-approved for heart failure | |