Due to the lack of evidence identified in this review for those with more severe CKD the committee noted this as an area warranting further research attention. In particular, the committee considered it important to establish the safety and optimal dosing for people with HFREF and more severe CKD (stages IIIb or greater). Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 6.2.7 All recommendations for the pharmacological treatment of heart failure 25.Diuretics should be routinely used for the relief of congestive symptoms and fluid retention in people with heart failure, and titrated (up and down) according to need following the initiation of subsequent heart failure therapies. [2003] 26.People who have heart failure with preserved ejection fraction should usually be offered a low to medium dose of loop diuretics (for example, less than 80 mg furosemide per day). People whose heart failure does not respond to this treatment will need further specialist advice. [2003, amended 2018] 6.2.7.2 Calcium-channel blockers 27.Avoid verapamil, diltiazem and short-acting dihydropyridine agents in people who have heart failure with reduced ejection fraction. [2003, amended 2018] 28.Make the decision to prescribe amiodarone in consultation with a specialist. [2003] 29.Review the need to continue the amiodarone prescription at the 6-monthly clinical 30.Offer people taking amiodarone liver and thyroid function tests, and a review of side effects, as part of their routine 6-monthly clinical review. [2003, amended 2018] 31.For people who have heart failure and atrial fibrillation, follow the recommendations on anticoagulation in the NICE guideline on atrial fibrillation. Be aware of the effects of impaired renal and liver function on anticoagulant therapies. 