Subcutaneous furosemide in an ambulatory heart failure clinic: a single center reflection on implementation

Subcutaneous (SC) furosemide offers an outpatient option for decongestion in chronic heart failure (HF) patients who remain symptomatic on oral diuretics or who would otherwise require recurrent intravenous (IV) therapy. Furoscix, the only FDA-approved SC furosemide, delivers 80 mg over 5 hours via an on-body infusor with pharmacokinetics and diuretic effects comparable to IV dosing. In this primer, we summarize the evidence supporting SC furosemide and share our institutional experience implementing it in a multidisciplinary ambulatory HF clinic, where it has now been prescribed to more than 75 patients. We argue that successful adoption depends less on the drug itself than on the workflows-patient selection, prescribing logistics, education, and post-administration monitoring-built around it, and we outline emerging opportunities to extend SC furosemide to advanced HF, hospital discharge, and emergency department transitions.