Subcutaneous Furosemide in Heart Failure: Pharmacokinetic Characteristics of a Newly Buffered Solution

JACC Basic Transl Sci. 2018 Feb 7;3(1):25-34. doi: 10.1016/j.jacbts.2017.10.001. eCollection 2018 Feb.

Abstract

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.

Keywords: ANOVA, analysis of variance; AUC, area under the curve; AUClast, last measurable plasma concentration; AUC∞, plasma concentration to infinity; CI, confidence interval; Cmax, peak plasma concentration; HF, heart failure; IV, intravenous; LSM, least squares mean; SC, subcutaneous; diuresis; furosemide; heart failure; pharmacokinetics; subcutaneous; t½, terminal phase elimination half-life.