TABLE 5.

Evidence-based drugs and oral doses as used in large clinical trials for prevention and treatment of heart failure

Drug	Start dose	Target dose
Angiotensin-converting enzyme inhibitors
Captopril	6.25 mg – 12.5 mg tid	25 mg – 50 mg tid
Enalapril	1.25 mg – 2.5 mg bid	10 mg bid
Lisinopril	2.5 mg – 5 mg od	20 mg – 35 mg od
Perindopril	2 mg	8 mg
Ramipril	1.25 mg – 2.5 mg bid	5 mg bid*
Trandolapril	1 mg	4 mg
Beta-blockers
Bisoprolol	1.25 mg od	10 mg od
Carvedilol	3.125 mg bid	25 mg bid
Metoprolol CR/XL†	12.5 mg – 25 mg od	200 mg od
Angiotensin receptor blockers
Candesartan	4 mg od	32 mg od
Valsartan	40 mg bid	160 mg bid
Aldosterone antagonists
Spironolactone	12.5 mg od	50 mg od
Eplerenone†	25 mg od	50 mg od
Vasodilators
Hydralazine	37.5 mg tid	75 mg tid
Isorbide dinitrate	20 mg tid	40 mg tid

^*The Healing and Early Afterload Reducing Therapy (HEART) trial (239) showed that 10 mg once a day (od) was effective to attenuate left ventricular remodelling.

^†Not available in Canada. bid Twice a day; CR/XL Controlled release/extended release; tid Three times a day