Version May 2024
| Type of therapy | Role in therapy | Typical initial dose (oral) | Target dose | Minimum dose titration interval |
| Isosorbide dinitrate plus hydralazine | Alternative to ARNI, ACE inhibitor, ARB; additional therapy for persistent symptoms; antihypertensive | 20 mg isosorbide dinitrate plus 25 mg hydralazine three times daily | 40 mg isosorbide dinitrate plus 100 mg hydralazine three times daily | 2 to 4 weeks or as tolerated |
| Isosorbide dinitrate/hydralazine fixed-dose combination pill | 20 mg/37.5 mg three times daily | 40 mg/75 mg three times daily | ||
| Ivabradine | Additional therapy for persistent symptoms; most appropriate for patients in sinus rhythm with HR ≥70 bpm despite maximal beta blocker therapy | 2.5 to 5 mg twice daily | 7.5 mg twice daily | 2 weeks or as tolerated |
| Vericiguat | Additional therapy for persistent symptoms; rarely used | 2.5 mg once daily | 10 mg once daily | 2 weeks or as tolerated |
| Digoxin | Additional therapy for persistent symptoms; rarely used | 0.0625 to 0.25 mg once daily* | Dose based on serum digoxin level* | |
ARNI: angiotensin receptor-neprilysin inhibitor; ACE: angiotensin converting enzyme; ARB: angiotensin II receptor blocker; HR: heart rate; bpm: beats per minute; HFrEF: heart failure with reduced ejection fraction.
* Loading dose not recommended. Initial dose is based upon kidney function and lean body weight; a nomogram is provided separately. Maintenance dose is adjusted to target a serum concentration of 0.5 to 0.8 ng/mL (0.64 to 1.0 nmol/L). For more information on digoxin use, refer to UpToDate content on pharmacologic treatment of heart failure.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
