41
Daily
Frequency Comments
1 Avoid routine use with beta blockers because of increased risk of
bradycardia and heart block.
Do not use in patients with HFrEF.
ere are drug interactions with diltiazem and verapamil (CYP3A4
major substrate and moderate inhibitor).
3
1 or 2
1 (in the evening)
2 ese are preferred diuretics in patients with symptomatic HF.
ey are preferred over thiazide-type diuretics in patients with
moderate-to-severe CKD (eg, GFR <30 mL/min).
e longer-acting choice of torsemide is preferred for treatment of
hypertension.
A loop diuretic is an option for patients who develop thiazide-type
diuretic associated hyponatremia.
2
1
1 or 2 As monotherapy, these agents are minimally effective
antihypertensive agents.
Combination therapy of a potassium-sparing diuretic with
a thiazide-type diuretic can be considered in patients with
hypokalemia on thiazide-type diuretic monotherapy.
Avoid use in patients with significant CKD (eg, GFR <45 mL/min).
1 or 2
1 or 2 ese are preferred agents in primary aldosteronism and resistant
hypertension.
Spironolactone is associated with greater risk of g ynecomastia and
impotence compared with eplerenone.
Demonstrated efficacy as fourth-agent add-on therapy for resistant
hypertension.
Avoid use with K+ supplements, other K+-sparing diuretics, or
significant renal dysfunction (eg, GFR <45 mL/min).
Eplerenone oen requires twice-daily dosing for adequate BP lowering.
Avoid use in pregnancy.
1
2 Beta blockers are not recommended as first-line agents unless the
patient has CHD or HF.
ese are preferred in patients with bronchospastic airway disease
requiring a beta blocker.
Bisoprolol and metoprolol succinate are preferred in patients with
HFrEF.
Avoid abrupt cessation.
1
1
2
1
