Subcutaneous Furosemide in Heart Failure

• Published in: JACC: Basic to Translational Science
• Main Authors: Domenic A. Sica, MD, Pieter Muntendam, MD, Rene L. Myers, PhD, Jozine M. ter Maaten, MD, PhD, Mark E. Sale, MD, Rudolf A. de Boer, MD, PhD, Bertram Pitt, MD
• Format: Article
• Language: English
• Published: Elsevier 2018-02-01
• Subjects: diuresis; furosemide; heart failure; pharmacokinetics; subcutaneous
• Online Access: http://www.sciencedirect.com/science/article/pii/S2452302X17302632
• ISSN: 2452-302X

Parenteral diuretics form the cornerstone of decongestion in heart failure. However, parenteral therapy routinely requires emergency room or inpatient care. A novel buffered furosemide formulation with neutral pH was developed to offer “hospital-strength” diuresis for outpatient use, including self-administration at home. Subcutaneous infusion using a biphasic delivery profile resulted in complete bioavailability (99.65%) and equivalent diuresis when compared with intravenous administration. Subcutaneous administration of buffered furosemide was well tolerated with no evidence of any drug-induced skin reactions. Subcutaneous infusion of buffered furosemide in the outpatient setting or home may help to reduce the burden of heart failure.