A Comparison of Hydrochlorothiazide and Metolazone in Combination With Furosemide in Congestive Heart Failure Patients
Congestive Heart Failure
![University of New Mexico](https://trials-media.s3.amazonaws.com/orgs/university-of-new-mexico.jpeg)
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.