Diuretic and clinical effects of low-dose furosemide in congestive heart failure patients.

A dose of 20 mg furosemide in congestive heart failure patients produces a significant diuretic and natriuretic effect. The peak effect was observed within 60-120 minutes in most patients. Twenty-four congestive heart failure patients were hospitalized for evaluation and management. Two withdrew from the study, and in three there was a prolonged (several months) remission of manifestations of congestive heart failure. The remaining 19 patients were treated with 40 mg furosemide per day for a four-week period. Six required 80 to 120 mg furosemide per day, and 13 were controlled on 40 mg per day. On 20 mg twice per day, one of the 13 patients dropped out voluntarily, two required a higher dose of furosemide, and 10 were controlled on this regimen for a four-week period. When dosage was reduced to 20 mg per day, five of the ten patients were controlled for an additional four weeks or longer, and five required higher doses of furosemide. Results of this study suggest that in congestive heart failure patients, 20 mg furosemide per day has significant diuretic and natriuretic properties. It also demonstrates that a number of patients with cardiac decompensation can be controlled on a relatively low dosage of furosemide and that periodic reevaluation of clinical status and diuretic requirements for maintenance therapy is of critical importance in management of patients with congestive heart failure.