All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 21. Offer people with heart failure vaccination against pneumococcal disease (only required once). [2003] 22. In women of childbearing potential who have heart failure, contraception and pregnancy should be discussed. If pregnancy is being considered or occurs, specialist advice should be sought. Subsequently, specialist care should be shared between the cardiologist and obstetrician. ]2003] 23. Air travel will be possible for the majority of people with heart failure, depending on their clinical condition at the time of travel. [2003] 24. Large Goods Vehicle and Passenger Carrying Vehicle licence: physicians should be up to date with the latest Driver and Vehicle Licensing Agency guidelines. Check the website for regular updates [2003] 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 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] 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. 29. Review the need to continue the amiodarone prescription at the 6-monthly clinical review. [2003, amended 2018] 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, 31. 