Table 14

Oral Diuretics Recommended for Use in the Treatment of Chronic HF

DrugInitial Daily Dose(s)Maximum Total Daily DoseDuration of Action
Loop diuretics
 Bumetanide0.5 to 1.0 mg once or twice10 mg4 to 6 h
 Furosemide20 to 40 mg once or twice600 mg6 to 8 h
 Torsemide10 to 20 mg once200 mg12 to 16 h
Thiazide diuretics
 Chlorothiazide250 to 500 mg once or twice1,000 mg6 to 12 h
 Chlorthalidone12.5 to 25.0 mg once100 mg24 to 72 h
 Hydrochlorothiazide25 mg once or twice200 mg6 to 12 h
 Indapamide2.5 mg once5 mg36 h
 Metolazone2.5 mg once20 mg12 to 24 h
Potassium-sparing diuretics
 Amiloride5 mg once20 mg24 h
 Spironolactone12.5 to 25.0 mg once50 mg1 to 3 h
 Triamterene50 to 75 mg twice200 mg7 to 9 h
Sequential nephron blockade
 Metolazone2.5 to 10.0 mg once plus loop diureticN/AN/A
 Hydrochlorothiazide25 to 100 mg once or twice plus loop diureticN/AN/A
 Chlorothiazide (IV)500 to 1,000 mg once plus loop diureticN/AN/A
  • Eplerenone, although also a diuretic, is primarily used in chronic HF.

  • Higher doses may occasionally be used with close monitoring.

  • See Section 8.4. HF indicates heart failure; IV, intravenous; and N/A, not applicable.