Table 11: Evidence-based drugs and oral doses as shown in large clinical trials

ACEI Drugs
Enalapril
Start Dose: 1.25-2.5 mg BID
Target Dose: 10 mg BID/ 20 BID in NYHA class IV
Lisinopril
Start Dose: 2.5-5 mg daily
Target Dose: 20-35 mg daily
Perindopril
Start Dose: 2-4 mg
Target Dose: 4-8 mg
Ramipril
Start Dose: 1.25-2.5 mg BID
Target Dose: 5 mg BID
Trandolapril
Start Dose: 1-2 mg daily
Target Dose: 4 mg daily

ARB Drugs
Candesartan
Start Dose: 4-8 mg daily
Target Dose: 32 mg daily
Valsartan
Start Dose: 40 mg BID
Target Dose: 160 mg BID

Beta-blockers Drugs
Carvedilol
Start Dose: 3.125mg BID
Target Dose: 25mg BID, 50mg BID (> 85kg)
Bisoprolol
Start Dose: 1.25mg daily
Target Dose: 10mg daily
Metoprolol CR/XL*
Start Dose: 12.5-25mg daily
Target Dose: 200mg daily

MRA Drugs
Spironolactone
Start Dose: 12.5mg daily
Target Dose: 50 mg daily
Eplerenone
Start Dose: 25 mg daily
Target Dose: 50 mg daily

ARNI Drugs
Sacubutril/Valsartan
Start Dose: 50-100 mg BID
Target Dose: 200 mg BID

If Inhibitor Drugs
Ivabradine
Start Dose: 2.5-5 mg BID
Target Dose: 7.5 mg BID

Vasodilators Drugs
Isosorbide dinitrate
Start Dose: 20 mg TID
Target Dose: 40 mg TID
Hydralazine
Start Dose: 37.5 mg TID
Target Dose: 75-100 mg TID-QID

* Limited evidence of short acting metoprolol tartrate in HF. Metoprolol CR/XL is not available in Canada.

ACEi, angiotensin-converting enzyme inhibitor;
ARB, angiotensin receptor blocker;
ARNI, angiotensin receptor-neprilysin inhibitor;
BID, twice per day;
CR/XL, Controlled Release/Extended Release;
HF, heart failure;
If, Inhibiting f-channel;
MRA, mineralocorticoid receptor antagonist;
NYHA, New York Heart Association;
QID, 4 times per day;
TID, 3 times per day.