What are the medications and brand names of Guideline-Directed Medical Therapy (GDMT) for Heart Failure (HF)?

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From the Guidelines

Guideline-directed medical therapy (GDMT) for heart failure includes several medication classes that have been proven to reduce mortality and hospitalizations, and the most recent guidelines recommend the use of ACE inhibitors, ARBs, ARNIs, beta-blockers, MRAs, SGLT2 inhibitors, and diuretics. The medications and brand names for GDMT in heart failure include:

  • ACE inhibitors: lisinopril (Prinivil, Zestril), enalapril (Vasotec), ramipril (Altace), and captopril (Capoten) 1
  • Angiotensin receptor blockers (ARBs): valsartan (Diovan), losartan (Cozaar), and candesartan (Atacand) 1
  • Angiotensin receptor-neprilysin inhibitors (ARNIs): sacubitril/valsartan (Entresto) 1
  • Beta-blockers: carvedilol (Coreg), metoprolol succinate (Toprol XL), and bisoprolol (Zebeta) 1
  • Mineralocorticoid receptor antagonists (MRAs): spironolactone (Aldactone) and eplerenone (Inspra) 1
  • SGLT2 inhibitors: dapagliflozin (Farxiga), empagliflozin (Jardiance), and canagliflozin (Invokana) 1
  • Diuretics: furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex) These medications work through different mechanisms, including reducing cardiac workload, preventing adverse remodeling, decreasing fluid retention, and improving cardiac metabolism, which collectively improve heart function and patient outcomes, as recommended by the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1.

The key points to consider when prescribing GDMT for heart failure include:

  • Initiating and titrating therapies to maximally tolerated doses to achieve the maximal benefits of GDMT in patients with chronic HFrEF 1
  • Using a combination of medications to reduce morbidity and mortality, unless contraindicated 1
  • Considering the use of SGLT2 inhibitors, which have been shown to reduce hospitalizations and improve outcomes in patients with heart failure 1
  • Monitoring patients regularly to adjust therapies and target doses, with the goal of improving heart function and patient outcomes 1.

From the FDA Drug Label

  1. 1 Adult Heart Failure Sacubitril and valsartan tablets are indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure and reduced ejection fraction.

The primary objective of PARADIGM-HF was to determine whether sacubitril and valsartan, a combination of sacubitril and an RAS inhibitor (valsartan), was superior to an RAS inhibitor (enalapril) alone in reducing the risk of the combined endpoint of cardiovascular (CV) death or hospitalization for heart failure (HF)

The medications and brand names of Guideline-Directed Medical Therapy (GDMT) for Heart Failure (HF) include:

  • Sacubitril/Valsartan (brand name not specified in the label)
  • Enalapril (an ACE inhibitor)
  • Beta-blockers (class of medication, not a specific brand name)
  • Mineralocorticoid antagonists (class of medication, not a specific brand name)
  • Diuretics (class of medication, not a specific brand name)

Note: The brand name for Sacubitril/Valsartan is not specified in the provided drug labels, but it is commonly known as Entresto 2, 2, 2.

From the Research

Guideline-Directed Medical Therapy (GDMT) for Heart Failure (HF)

The following medications are used in GDMT for HF:

  • Angiotensin Converting Enzyme Inhibitors (ACEi) 3, 4, 5
  • Angiotensin Receptor-Neprilysin Inhibitors (ARNI) 3, 6, 4, 5
  • Angiotensin Receptor Blockers (ARB) 3, 6, 4, 5
  • Beta-Blockers (BB) 3, 6, 4, 7, 5
  • Mineralocorticoid Receptor Antagonists (MRA) 3, 6, 4, 5

Brand Names of GDMT Medications

Some brand names of these medications include:

  • Sacubitril/Valsartan (ARNI) 6
  • Vericiguat (soluble guanylate cyclase stimulator) 6
  • Elamipretide (myocardial energetics and mitochondrial function) 6
  • Omecamtiv-mecarbil (myocardial energetics and mitochondrial function) 6

Medication Classes and Their Effects

These medication classes work by:

  • Blunting the activation of detrimental neurohormonal axes, namely sympathetic and renin-angiotensin-aldosterone (RAAS) systems 6
  • Inhibiting the RAAS system and potentiating the counter-regulatory natriuretic peptide system 6
  • Improving cardiac contractility, metabolism, fibrosis, inflammation, and remodeling 6

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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