digoxin + furosemide + captopril

This is a combination therapy consisting of three well-established pharmaceutical agents—digoxin, furosemide, and captopril—commonly used in the management of moderate to severe congestive heart failure. - **Digoxin** is a cardiac glycoside that increases myocardial contractility (positive inotropy) and slows heart rate (negative chronotropy) by inhibiting the Na-K ATPase enzyme in cardiac cells. - **Furosemide** is a loop diuretic that promotes diuresis by inhibiting sodium and chloride reabsorption in the ascending limb of the loop of Henle, reducing fluid overload and edema. - **Captopril** is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and reduces afterload by blocking conversion of angiotensin I to angiotensin II, leading to vasodilation. The combination targets multiple pathophysiological aspects of heart failure: - Digoxin improves cardiac output. - Furosemide relieves symptoms related to fluid overload. - Captopril reduces both preload and afterload while providing renal protection. Clinical studies have shown this regimen can improve exercise tolerance, reduce symptoms, promote natriuresis/diuresis, correct hyponatremia, and enhance overall hemodynamic status in patients with moderate or severe heart failure not adequately controlled on monotherapy[1][2][5].