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GENERAL MEDICINE

Diuretic Effects of Subcutaneous Furosemide in Human Volunteers: A Randomized Pilot Study

PhD Candidate, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada

Jack H da Silva, BSc BSc(Pharm)

Pharmacy Coordinator, Ambulatory Pharmacy, Pharmacy Department, St. Paul's Hospital, Vancouver

David R Kuhl, MD PhD

Physician, Department of Family and Community Medicine, St. Paul's Hospital

Reprints: Arun K Verma BSc BSc(Pharm) MSc, Faculty of Pharmaceutical Sciences, University of British Columbia, 2146 E. Mall, Vancouver, BC, V6T 1Z3, Canada, fax 604/822-3035, averma{at}interchange.ubc.ca

BACKGROUND: Furosemide is usually administered by the oral or intravenous route to cardiac patients with hypertension and heart failure, as well as edema. Occasionally, furosemide cannot be administered by these routes.

OBJECTIVE: To evaluate the diuretic/natriuretic efficacy of subcutaneously administered furosemide in healthy volunteers.

METHODS: This single-center, double-blind, placebo-controlled, randomized, crossover pilot study compared the diuretic effect of subcutaneously administered furosemide and NaCl 0.9% (placebo) in 12 healthy volunteers. The study was conducted over 5 days. Baseline values were determined on day 1. On days 3 and 5, each volunteer was injected with either furosemide 20 mg (2 mL) or 2 mL of placebo subcutaneously. A washout period occurred on day 4. Fluid and dietary intake were controlled on all 3 data collection days. Primary outcome measures consisted of urine volume voided, urine sodium concentration, onset time and volume of initial urine output, and number of voids during 8 hours of urine collection.

RESULTS: All outcomes demonstrated statistically significant differences when treatment and placebo groups were compared (p < 0.05). Adverse effects most commonly reported by the participants were minor and included transient burning and stinging at the injection site.

CONCLUSIONS: This study demonstrates that subcutaneously administered furosemide is a viable alternative when the oral or intravenous route of administration is not desirable or possible in humans. However, the results of this study need to be corroborated in various patient populations.

Key Words: furosemide, subcutaneous

Published Online, February 24, 2004. www.theannals.com, DOI 10.1345/aph.1D332

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