Table 6

Inhibitors of the Renin-Angiotensin-Aldosterone System and Beta Blockers Commonly Used for the Treatment of Patients With HF With Low Ejection Fraction

DrugInitial Daily Dose(s)Maximum Doses(s)
ACE Inhibitors
 Captopril6.25 mg 3 times50 mg 3 times
 Enalapril2.5 mg twice10 to 20 mg twice
 Fosinopril5 to 10 mg once40 mg once
 Lisinopril2.5 to 5 mg once20 to 40 mg once
 Perindopril2 mg once8 to 16 mg once
 Quinapril5 mg twice20 mg twice
 Ramipril1.25 to 2.5 mg once10 mg once
 Trandolapril1 mg once4 mg once
Angiotensin Receptor Blockers
 Candesartan4 to 8 mg once32 mg once
 Losartan25 to 50 mg once50 to 100 mg once
 Valsartan20 to 40 mg twice160 mg twice
Aldosterone Antagonists
 Spironolactone12.5 to 25 mg once25 mg once or twice
 Eplerenone25 mg once50 mg once
Beta Blockers
 Bisoprolol1.25 mg once10 mg once
 Carvedilol3.125 mg twice25 mg twice
50 mg twice for patients >85 kg
 Metoprolol succinate extended release (metoprolol CR/XL)12.5 to 25 mg once200 mg once

ACE indicates angiotensin converting enzyme; kg, kilograms, and mg, milligrams.