TABLE 1

Commonly used diuretics and doses in chronic heart failure

Drug	Starting daily dose	Maximum recommended total daily dose	Duration of action
Loop diuretics
Bumetanide	PO/IV: 0.5–1.0 mg once or twice	PO/IV: 10 mg	4–6 hr
Furosemide	PO/IV: 20–40 mg once or twice	PO/IV: 600 mg	6–8 hr
Torsemide	PO: 10–20 mg once	PO/IV: 200 mg	12–16 hr
Thiazide diuretics^a
Chlorothiazide	PO: 250–500 mg once or twice	PO: 1,000 mg	6–12 hr
Chlorthalidone	PO: 12.5–25 mg once	PO: 100 mg	24–2 hr
Hydrochlorothiazide	PO: 25 mg once or twice	PO: 200 mg	6–12 hr
Indapamide	PO: 2.5 mg once	PO: 5 mg	36 hr
Metolazone	PO: 2.5 mg once	PO: 20 mg	12–24 hr
Carbonic anhydrase inhibitors
Acetazolamide	PO: 250–375 mg once IV: 500 mg once	PO/IV: 1,500 mg	PO: 18–24 hr IV: 4–5 hr
Potassium-sparing diuretics
Amiloride	PO: 5 mg once	PO: 20 mg	24 hr
Triamterene	PO: 50–75 mg twice	PO: 200 mg	7–9 hr
Spironolactone	PO: 12.5–25 mg once	PO: 100 mg	24 hr^b

↵a Sequential nephron blockade dose of metolazone is 2.5 to 10 mg once daily (PO), hydrochlorothiazide 25 to 100 mg once or twice daily (PO), and chlorothiazide 500 to 1,000 mg once daily (IV), all 30 minutes before loop diuretics.
↵b Duration of action based on half-life of canrenone, the active metabolite of spironolactone. IV = intravenous; PO = oral
Based on data from references 1, 4, and 5.