Drugs for Heart Failure 2013

Medications used to treat congestive heart failure include ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and other medications. The dosages below represent the usual daily dosages for the treatment of heart failure. The precise effective dosage varies from person to person and depends on many factors. Do not make any changes to your medication without consulting your doctor. Instructions for taking these drugs represent the typical way to take the medication. Your doctor's instructions may differ. Always follow your doctor's recommendations.

ACE Inhibitors to Treat CHF

  • Accupril (quinapril)—20-40 mg; one 10 or 20 mg tablet 2x/day on an empty stomach, 1 hour before or 2 hours after a meal or with a light, low-fat meal.
  • Altace (ramipril)—10 mg; one 5 mg capsule 2x/day with or without food. Swallow capsule whole.
  • Capoten (captopril)—75-300 mg; one 25, 50 or 100 mg tablet 3x/day on an empty stomach 1 hour before meals.
  • Mavik (trandolapril)—4 mg; one 4 mg tablet 1x/day with or without food.
  • Monopril (fosinopril)—20-40 mg; one 10, 20 or 40 mg tablet 1x/day with or without food.
  • Prinivil, Zestril (lisinopril)—5-20 mg (Prinivil), 5-40 mg (Zestril); one 5, 10, 20, 30 or 40 mg tablet 1x/day with or without food.
  • Vasotec (enalapril)5-40 mg; one 2.5, 5, 10, or 20 mg tablet 2x/day with or without food.

ACE inhibitors can raise potassium levels; do not take potassium supplements or use salt substitutes containing potassium without your doctor's knowledge. Do not take if you are pregnant or could become pregnant. To minimize dizziness, get up slowly from a seated or lying position and avoid dehydration.

Common side effects include dry cough, dizziness, sore throat. Call your doctor if you experience a dry cough or symptoms of angioedema; swelling of your face, eyes, lips or tongue; or difficulty swallowing or breathing.

ARBs to Treat CHF

  • Atacand (candesartan)—4-32 mg; one 4, 8, 16 or 32 mg tablet 1x/day with or without food.
  • Diovan (valsartan)—80-320 mg; one 40, 80 or 160 mg tablet 2x/day with or without food.

Like ACE inhibitors, ARBs can raise potassium levels; do not take potassium supplements or use salt substitutes containing potassium without your doctor’s knowledge. Do not take if you are pregnant or could become pregnant. To minimize dizziness, get up slowly from a seated or lying position and avoid dehydration.

Common side effects include back pain, dizziness, cold-like symptoms such as sore throat and stuffy nose. Call your doctor if you experience symptoms of kidney problems: sudden weight gain and swelling of your arms, hands, legs and feet.

Beta-blockers to Treat CHF

  • Coreg (carvedilol)—6.25-50 mg; one 3.125, 6.25, 12.5 or 25-mg tablet 2x/day with food.
  • Coreg CR (carvedilol, extended-release)—10-80 mg; one 10, 20, 40 or 80-mg capsule 1x/day in morning with food. Swallow whole (do not crush or chew).
  • Toprol XL (metoprolol, extendedrelease)—25-200 mg; one 25, 50, 100 or 200-mg tablet 1x/day with or immediately after a meal. Swallow whole (do not crush or chew).

Do not stop taking beta-blockers without consulting your doctor. To minimize dizziness, get up slowly from a seated or lying position and avoid alcohol. May reduce blood flow to the hands and feet, making them cold. To prevent this side effect, dress warmly and avoid smoking. May mask symptoms of hypoglycemia (low blood glucose) in people with diabetes who are taking insulin or certain oral diabetes drugs.

Common side effects include dizziness, drowsiness, diarrhea, trouble sleeping, dry eyes. Call your doctor if you experience symptoms of worsening heart failure: weight gain or worsening shortness of breath; symptoms of a very slow heart rate: persistent dizziness, faintness, unusual fatigue; changes in blood glucose levels if you have diabetes.

Publication Review By: Gary Gerstenblith, M.D.; Simeon Margolis, M.D., Ph.D.

Published: 03 Jul 2013

Last Modified: 03 Jul 2013