Subcutaneous Furosemide, a Novel Therapy With Potential to Reduce Heart Failure Burden.

Area of Science:

• Cardiology
• Pharmacology
• Internal Medicine

Background:

• Heart failure (HF) is a global health issue requiring new therapeutic strategies.
• Furosemide, a loop diuretic, is a first-line agent for volume management in chronic HF.
• Oral furosemide efficacy decreases in decompensated HF due to intestinal edema, often necessitating hospitalization for intravenous (IV) administration.

Purpose of the Study:

• To evaluate novel subcutaneous (SC) furosemide formulations as an alternative to oral administration.
• To assess the potential of SC furosemide to reduce hospitalizations in volume-overloaded HF patients.

Main Methods:

• Review of numerous small randomized controlled trials (RCTs) assessing SC furosemide safety and efficacy.
• Comparison of diuresis achieved with SC furosemide versus IV furosemide.

Main Results:

• Small RCTs demonstrated comparable diuresis with SC and IV furosemide.
• Multiple SC furosemide formulations have received Food and Drug Administration approval.
• SC furosemide shows promise as an outpatient alternative to oral furosemide.

Conclusions:

• Subcutaneous furosemide is a safe and effective alternative to oral furosemide for stable, volume-overloaded outpatients.
• SC furosemide can potentially decrease unnecessary hospitalizations for heart failure management.
• Further large-scale RCTs are needed to establish definitive outpatient guidelines for SC furosemide use.