Oral Diuretics Recommended for Use in the Treatment of Chronic Heart Failure

Diuretics Used In Heart Failure

Oral Diuretics Recommended for Use in the Treatment of Chronic Heart Failure
Drug	Initial Daily Dose(s)	Maximum Total Daily Dose	Duration of action
Loop Diuretics
Bumetanide	Oral: 0.5 to 1 mg qd-bid	10 mg	4 to 6 hours
Furosemide	Oral: 20 to 40 mg qd-bid	600 mg	6 to 8 hours
Torsemide	Oral: 10 to 20 mg qd	200 mg	12 to 16 hours
Thiazide Diuretics
Chlorthiazide	250-500 mg qd-bid	1000 mg	6 to 12 hours
Chlorthalidone	12.5 to 25 mg qd	100 mg	24 to 72 hours
Hydrochlorothiazide	25 mg qd - bid	200 mg	6 to 12 hours
Indapamide	2.5 mg qd	5 mg	36 hours
Metolazone	2.5 mg qd	20 mg	12 to 24 hours
Potassium-sparing diuretics
Amiloride	5 mg qd	20 mg	24 hours
Spironolactone	12.5 to 25 mg qd	50 mg (possibly higher doses in select cases)	2 to 3 days
Triamterene	50 to 75 mg bid	200 mg	7 to 9 hours
Sequential Nephron blockade
Metolazone	2.5 to 10 mg qd plus loop diuretic
Hydrochlorothiazide	25 to 100 mg qd-bid plus loop diuretic
Chlorthiazide (IV)	500 to 1000 mg qd plus loop diuretic
Intravenous Diuretic Medications Useful for the Treatment of Severe Heart Failure
Loop Diuretics
Drug	Initial dose	Max single dose
Bumetanide	1 mg	4 to 8 mg
Furosemide	40 mg	160 to 200 mg
Torsemide	10 mg	100 to 200 mg
Thiazide Diuretics
Chlorthiazide	500mg	1000 mg
Intravenous Infusions
Bumetanide	1 mg IV load, then 0.5 to 2 mg per hour
Furosemide	40 mg IV load, then 10 to 40 mg per hour
Torsemide	20 mg IV load, then 5 to 20 mg per hour

Reference

Direct quotes from this valuable reference:
Hunt SA, Abraham WT, Chin MH, Feldman AM, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20;112(12):e154-235. Epub 2005.
Link: http://circ.ahajournals.org/cgi/content/full/112/12/e154

Disclaimer

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Reference

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