| Creatinine clearance* is ≥60 mL/min/1.73 m2 |
|---|
| New-onset HF or no maintenance diuretic therapy |
| Initial IV dose**: Furosemide 20-40 mg 2-3 times daily. |
| Maintenance dose: Lowest diuretic dose that allows for clinical stability is the ideal dose. |
| Established HF or chronic oral diuretic therapy |
| Initial IV dose**: Furosemide bolus equivalent to oral dose. |
| Creatinine clearance* is <60 mL/min/1.73 m2 |
| New-onset HF or no maintenance diuretic therapy |
| Initial IV dose**: Furosemide 20-80 mg 2-3 times daily. |
| Established HF or chronic oral diuretic therapy |
| Initial IV dose**: Furosemide bolus equivalent to oral dose. |
* Creatinine clearance is calculated from the Cockroft-Gault or Modified Diet in Renal Disease formula.
** Intravenous continuous furosemide at doses of 5 to 20 mg/h is also an option.