Peer-reviewedCC BYClinical cardiology1 Nov 2026

Subcutaneous Furosemide for Ambulatory Decongestion in Heart Failure: Outcomes From a High-Risk Real-World Cohort.

Omar Jafar¹
Ann Harper²
Angela Toepp²
Amin Yehya³

¹Internal Medicine, Macon & Joan Brock Virginia Health Science at Old Dominion University, Norfolk, Virginia, USA.
²Sentara Enterprise Analytics, Vigrinia Beach, Virginia, USA.
³Cardiology, Macon & Joan Brock Virginia Health Science at Old Dominion University, Norfolk, Virginia, USA.

Abstract

Background

Volume overload remains a primary driver of heart failure hospitalization (HFH). Diuretic resistance limits the efficacy of oral loop diuretics during decompensation, often necessitating intravenous therapy. Subcutaneous (SC) furosemide (Furoscix, 80 mg/10 mL) represents a novel outpatient alternative for patients who remain symptomatic despite oral diuretic therapy.Objectives

To evaluate the clinical outcomes of SC furosemide in ambulatory heart failure (HF) patients inadequately managed with oral loop diuretics.Methods

We performed a single-center retrospective cohort study of HF patients prescribed SC furosemide as an adjunct to oral loop diuretics between May 2023 and 2025. The primary outcome was HFH within 30 days of initiation. Secondary outcomes included a composite of HFH or urgent care or emergency department visits requiring intravenous diuresis, change in body weight, and New York Heart Association (NYHA) functional class.Results

Fifty patients met the inclusion criteria; one was excluded for incomplete follow-up. SC furosemide was prescribed as two to three doses per week. Within 30 days, 10 patients (20.4%) experienced HFH; six had been hospitalized in the preceding 30 days, suggesting a high-risk baseline cohort. The composite endpoint occurred in 16 patients (32.7%). Among patients who avoided hospitalization, median NYHA class improved from III to II, and mean body weight decreased by 2.6 kg (5.7 lbs). Adverse events were infrequent; no deaths occurred within the 30-day follow-up period.Conclusion

In ambulatory HF patients with persistent congestion despite oral diuretic therapy, SC furosemide was well tolerated and associated with improvements in functional status and volume burden.

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Cite

BibTeX RIS

BibTeX

@article{jafar2026subcutaneous,
  title = {{Subcutaneous Furosemide for Ambulatory Decongestion in Heart Failure: Outcomes From a High-Risk Real-World Cohort.}},
  author = {Omar Jafar and Ann Harper and Angela Toepp and Amin Yehya},
  journal = {Clinical cardiology},
  year = {2026},
  month = nov,
  doi = {10.1002/clc.70514},
  url = {https://europepmc.org/article/MED/42974904},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Subcutaneous Furosemide for Ambulatory Decongestion in Heart Failure: Outcomes From a High-Risk Real-World Cohort.
AU  - Omar Jafar
AU  - Ann Harper
AU  - Angela Toepp
AU  - Amin Yehya
PY  - 2026
DA  - 2026/11/01
JO  - Clinical cardiology
DO  - 10.1002/clc.70514
UR  - https://europepmc.org/article/MED/42974904
AB  - Background  Volume overload remains a primary driver of heart failure hospitalization (HFH). Diuretic resistance limits the efficacy of oral loop diuretics during decompensation, often necessitating intravenous therapy. Subcutaneous (SC) furosemide (Furoscix, 80 mg/10 mL) represents a novel outpatient alternative for patients who remain symptomatic despite oral diuretic therapy.Objectives  To evaluate the clinical outcomes of SC furosemide in ambulatory heart failure (HF) patients inadequately managed with oral loop diuretics.Methods  We performed a single-center retrospective cohort study of HF patients prescribed SC furosemide as an adjunct to oral loop diuretics between May 2023 and 2025. The primary outcome was HFH within 30 days of initiation. Secondary outcomes included a composite of HFH or urgent care or emergency department visits requiring intravenous diuresis, change in body weight, and New York Heart Association (NYHA) functional class.Results  Fifty patients met the inclusion criteria; one was excluded for incomplete follow-up. SC furosemide was prescribed as two to three doses per week. Within 30 days, 10 patients (20.4%) experienced HFH; six had been hospitalized in the preceding 30 days, suggesting a high-risk baseline cohort. The composite endpoint occurred in 16 patients (32.7%). Among patients who avoided hospitalization, median NYHA class improved from III to II, and mean body weight decreased by 2.6 kg (5.7 lbs). Adverse events were infrequent; no deaths occurred within the 30-day follow-up period.Conclusion  In ambulatory HF patients with persistent congestion despite oral diuretic therapy, SC furosemide was well tolerated and associated with improvements in functional status and volume burden.
SN  - 0160-9289
SN  - 1932-8737
ER  -

Abstract

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