Important:

A diuretic is not always necessary as maintenance treatment in a patient with heart failure. This should only be prescribed if there are signs of fluid retention. The lowest maintenance dose of a loop diuretic should always be aimed for while euvolemia and target weight are maintained. Sometimes it is possible and even better, especially with HFrEF, to stop diuretics, provided that fluid retention does not occur quickly afterwards. Blood pressure will be slightly higher after discontinuation of diuretics and there will thus be more opportunity for up-titration of the neurohormonal blockers to the maximum tolerated dose. In contrast to diuretics, these neurohormonal blockers have a proven positive effect on the prognosis of patients with HFrEF.

Important:

The correct dose of diuretics is often dynamic over time and must be adapted to clinical evolution, weight, renal function, ionogram,...