A Comparison of Hydrochlorothiazide and Metolazone in Combination With Furosemide in Congestive Heart Failure Patients
Congestive Heart Failure
About this trial
This is an interventional treatment trial for Congestive Heart Failure focused on measuring congestive heart failure, diuretics, combination
Eligibility Criteria
Inclusion Criteria:
- Age >18 years
- Diagnosis of chronic congestive heart failure with an ejection fraction ≤45%
- Currently on a stable regimen of furosemide consisting of a daily dose of at least 80 mg for at least two weeks.
- Patients receiving ACE-inhibitors and/or beta-blockers must be taking these medications for at least two weeks in stable doses.
Exclusion Criteria:
- Renal dysfunction (serum creatinine >2 mg/dl or creatinine clearance of <30 ml/min as calculated by the Cockroft and Gault equation)
- Hepatic dysfunction (AST and ALT >3 times the upper limit of the normal)
- Hypokalemia (<4.0 mg/dl)
- Concomitant treatment with any diuretic other than furosemide (with the exception of spironolactone).
Sites / Locations
- University Of New Mexico HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
1
2
Patients will be randomized to receive either metolazone or HCTZ in a randomized, double-blind, placebo controlled crossover trial. The patients will receive the alternative medication if The specific dose of hydrochlorothiazide will be determined by the individual's creatinine clearance. A creatinine clearance of 30-50 mL/min will indicate a dose of 50 mg per day. A creatinine clearance of > 50 mL/min will indicate a dose of 25 mg per day.5 If metolazone is added to their regimen, the specific dose will be determined using the equivalence ratio of 5 mg metolazone to 50 mg hydrochlorothiazide.
Patients will be randomized to receive either metolazone or HCTZ in a randomized, double-blind, placebo controlled crossover trial. The patients will receive the alternative medication if The specific dose of hydrochlorothiazide will be determined by the individual's creatinine clearance. A creatinine clearance of 30-50 mL/min will indicate a dose of 50 mg per day. A creatinine clearance of > 50 mL/min will indicate a dose of 25 mg per day.5 If metolazone is added to their regimen, the specific dose will be determined using the equivalence ratio of 5 mg metolazone to 50 mg hydrochlorothiazide.