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

•Parenteral diuretics form the cornerstone of treatment of fluid overload in heart failure. The alkaline pH of furosemide USP precludes SC administration.•A novel buffered formulation of furosemide (pH 7.4) was developed for SC infusion using a wearable patch pump.•A 5-h biphasic SC infusion (30 mg in hour 1 followed by 12.5 mg/h for 4 h) of the novel formulation was tested in 2 clinical studies.•Following SC administration, therapeutic levels of furosemide were reached within 30 min and maintained for up to 6 h. This resulted in complete bioavailability and equivalent diuresis when compared with 80 mg of intravenous furosemide.•A novel strategy using SC administration of buffered furosemide is introduced for outpatient use, including self-administration at home. This may help to reduce the patient and economic burden of heart failure.