Table 16.

Guideline directed medical therapy for heart failure-medications shown to improve survival^# (2, 3)

	Daily starting dose	Daily target dose
Angiotensin converting enzyme (ACE) inhibitor
Captopril	6.25 mg t.i.d	50 mg t.i.d
Enalapril	2.5 mg b.i.d	10-20 mg b.i.d
Lisinopril	2.5-5 mg o.d	40 mg o.d
Ramipril	1.25-2.5 mg o.d	5 twice or 10 mg o.d
Trandolapril	0.5-1 mg o.d	4 mg o.d
Beta-blocker
Bisoprolol	1.25 mg o.d	10 mg o.d
Carvedilol	3.125 mg b.i.d	25-50 mg b.i.d
Metoprolol succinate (CR/XL)	12.5-20 mg o.d	200 mg o.d
Nebivolol*	1.25 mg o.d	10 mg o.d
Angiotensin receptor blocker
Candesartan	4-8 mg o.d	32 mg o.d
Valsartan	40 mg b.i.d	160 mg b.i.d
Losartan	50 mg o.d	150 mg o.d
Aldosterone antagonists
Eplerenone	25 mg o.d	50 mg o.d
Spironolactone	25 mg o.d	25-50 mg o.d
Hydralazine and isosorbide dinitrate
Hydralazine	25 to 50 mg t.i.d or four times	300 mg daily in divided doses
Isosorbide dinitrate	20 to 30 mg t.i.d or four times	120 mg daily in divided doses

^#Modified from ESC 2012 and ACCF/AHA heart failure guidelines

^*Recommended by ESC but not by ACCF/AHA guidelines