Medication	Special indications	Target daily dose*	Contraindications	Adverse effects	Monitoring and testing
Statins	Recommended for all patients	High-intensity dosing: atorvastatin 40 or 80 mg; rosuvastatin 20 or 40 mg	Active liver disease or severely elevated liver transaminase levels (> 3 to 5 times the normal limit)	Arthralgia, elevated liver transaminase levels, gas-trointestinal symptoms, headache, myalgias	Obtain LFTs and lipid panel before initiation, consider creatine kinase levels in patients with symptoms of myopathy
Ezetimibe	Consider in patients already on maximally tolerated statin dose with low-density lipoprotein > 70 mg per dL (1.81 mmol per L)	10 mg	Active liver disease	Elevated hepatic enzymes	Obtain LFTs and lipid panel before initiation
Beta blockers	Recommended for all patients; consider strongly if reduced LVEF	Various; consider stopping after 2 to 3 years if patient has adverse effects and no other indications	Second- or third-degree heart block, severe bradycardia	Bronchospasm, decreased heart rate, depression, fatigue, hypoglycemia, sexual dysfunction	Monitor heart rate, consider discontinuation in patients with symptomatic bradycardia
ACE inhibitor/ARB	Consider if patient has reduced LVEF or diabetes mellitus; ARB/neprilysin inhibitor may be preferred if LVEF < 40%	Various	History of anaphylaxis or angioedema	Cough/angioedema (more common with ACE inhibitor), hyperkalemia, hypotension, reduced estimated glomerular filtration rate	Monitor blood pressure, recommend obtaining BMP before initiation and while on therapy; consider complete blood count for patients with underlying chronic kidney disease
Mineralocorticoid receptor antagonists	Consider if LVEF < 40%	Spironolactone 12.5 or 25 mg; eplerenone 25 or 50 mg	Potassium level > 5.5 mEq per L (5.5. mmol per L) or CrCl < 30 mL per minute	Decreased libido, fatigue, gynecomastia, headache, hyperkalemia, menstrual irregularities	Monitor blood pressure and hydration status; obtain BMP and uric acid measurement before initiation and while on therapy
SGLT2 inhibitor	Consider for all patients; consider strongly for those with diabetes or heart failure regardless of LVEF	Empagliflozin (Jardiance) 10 or 25 mg; dapagliflozin (Farxiga) 5 or 10 mg	CrCl < 45 mL per minute for dapagliflozin; CrCl < 30 mL per minute for empagliflozin	Acute kidney injury, euglycemic diabetic ketoacidosis, genitourinary tract infections, hypotension	Monitor blood pressure and hydration status, obtain BMP before initiation and while on therapy
GLP-1 agonist	Consider if patient has diabetes	Various	Medullary thyroid cancer, multiple endocrine neoplasia type 2, pancreatitis	Acute kidney injury, gastrointestinal discomfort, gallbladder disease, pancreatitis	Consider obtaining BMP and A1C level before initiation and while on therapy