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Brand Name :
Antivirals, CMV; Foscavir
Synonyms :
foscarnet
Class :
Antivirals, CMV; Other
Brand Name :
Antivirals, CMV; Foscavir
Synonyms :
foscarnet
Class :
Antivirals, CMV; Other
Dosage forms & Strengths:
Adult:
Solution for injection
2.4 gm/100 ml
Loading dose- 60 mg/kg every 8 hours intravenously for 21 days. Give the infusion for 60 minutes
Maintenance dose- 90-120 mg/kg intravenously each day. Give the infusion for 60-90 minutes
Either- 40 mg/kg intravenously every 8 hours for 14-21 days over 60 minutes
Or- 40-60 mg intravenously every 12 hours for 14-21 days over 60 minutes
Safety and efficacy are not seen in pediatrics.
Refer to the adult dosing
dasatinib may enhance the QTc-prolonging effect of QT-prolonging
may enhance the Qtc prolonging effect
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
may have an increased QTc-prolonging effect when combined with doxepin-containing products
may increase the QTc-prolonging effect of QT-prolonging Agents
dronedarone: they may increase the QTc-prolonging effect of QTc-prolonging miscellaneous agents
gilteritinib: they may increase the QTc-prolonging effect of QTc-prolonging agents
halofantrine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
osimertinib: they may increase the QTc-prolonging effect of QTc-prolonging Agents
pentamidine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
may enhance the QTc-prolonging effect of each other when combined
may enhance the QTc-prolonging effect of each other when combined
chloroquine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
dasatinib: they may increase the QTc-prolonging effect of QTc-prolonging Agents
methadone: they may increase the QTc-prolonging effect of QTc-prolonging Agents
QTc prolonging effect of azithromycin is increased with QT-prolonging class III Antiarrhythmics
may have an increased nephrotoxic effect when combined with amphotericin B
it increases the nephrotoxicity of aminoglycosides
neomycin/polymyxin B/bacitracin topical
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
it increases the nephrotoxicity of aminoglycosides
It may enhance QTc interval when combined with lithium
It may enhance the QTc interval when combined with efavirenz
may increase the nephrotoxic effect
may have an increased QTc-prolonging effect when combined with levoketoconazole
may have an increased QTc-prolonging effect when combined with nilotinib
May increase the QTc-prolonging effect of QT-prolonging Agents
may increase the QTc-prolonging effect of QT-prolonging Agents
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
pazopanib: they may increase the QTc-prolonging effect of QTc-prolonging Agents
quetiapine: they may increase the QTc-prolonging effect of QTc-prolonging Agents
ribociclib: they may increase the QTc-prolonging effect of QTc-prolonging Agents
may increase the QTc-prolonging effect of each other when combined
may increase the QTc-prolonging effect of each other when combined
may increase the QTc-prolonging effect of each other when combined
may increase the QTc-prolonging effect of each other when combined
may increase the QTc-prolonging effect of each other when combined
the QTc-prolonging effect of clarithromycin can be increased with QT-prolonging agents
QT-prolonging Miscellaneous Agents may enhance the QTc-prolonging effect of anti-arrhythmics
QT-prolonging Miscellaneous Agents may enhance the QTc-prolonging effect of anti-arrhythmics
QT-prolonging Miscellaneous Agents may enhance the QTc-prolonging effect of anti-arrhythmics
QT-prolonging Miscellaneous Agents may enhance the QTc-prolonging effect of anti-arrhythmics
QT-prolonging Miscellaneous Agents may enhance the QTc-prolonging effect of anti-arrhythmics
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
when both drugs are combined, both increase the QTC interval  
QT-prolongers increase the effect of QTc prolongation of haloperidol
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
they increase the risk of other QT prolongers
may increase the QTc prolonging effect of QT-prolonging agents
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may have an increased QTc-prolonging effect when combined with QT-prolonging agents
certoparin: it may increase the risk or severity of QTc prolongation
benoxaprofen: it may increase the risk or severity of QTc prolongation agents
cabozantinib: it may increase the risk or severity of QTc prolongation agents
The serum concentration of foscarnet can be enhanced by the concurrent use of loop diuretics
The serum concentration of foscarnet can be enhanced by the concurrent use of loop diuretics
The serum concentration of foscarnet can be enhanced by the concurrent use of loop diuretics
when used in combination, pazopanib, and foscarnet both increase the QTc interval
Actions and Spectrum:
The mechanism of action of foscarnet involves inhibiting the activity of the viral DNA polymerase, thereby preventing the replication of the virus.
>10%:
Nausea (47%)
Fever (65%)
Headache (26%)
Vomiting (33%)
Anemia (33%)
Seizures (10%)
Diarrhea (30%)
1-10%:
Depression
Fatigue
Anxiety
Confusion
Hypoesthesia
Neutropenia
Leukopenia
Rash
Black Box Warning:
It is essential to follow the dosage and administration instructions for the medication carefully.
Contraindication/Caution:
Renal impairment: foscarnet is eliminated primarily through the kidneys, and dose adjustments may be necessary for patients with impaired renal function.
Electrolyte imbalances: foscarnet can cause electrolyte imbalances, particularly hypocalcemia and hypomagnesemia. Hence monitor the electrolyte levels regularly.
Infusion-related reactions: foscarnet should be administered slowly due to the risk of infusion-related reactions, such as fever, chills, and hypotension.
Other medications: foscarnet may interact with other medications, including other antiviral drugs, so it is essential to inform your doctor of all medications you are taking.
Pregnancy/Lactation
Pregnancy consideration:
Category C.
Breastfeeding warnings:
Do not breastfeed during the medication.
Pregnancy category:
Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: No data is available for the drug under this category.
Pharmacology
foscarnet interferes with viral DNA synthesis by binding to the pyrophosphate site of viral DNA polymerase, inhibiting its activity and thus preventing the replication of the virus.
foscarnet is active against herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and varicella-zoster virus (VZV), the virus responsible for shingles and chickenpox. It is also active against cytomegalovirus (CMV) in patients who are intolerant to other antiviral drugs.
Pharmacodynamics:
foscarnet inhibits the activity of the viral DNA polymerase, preventing replication of the virus. It also interferes with the stability of the viral genome, leading to its degradation. Pharmacokinetics:
Pharmacokinetics studies how a drug is absorbed, distributed, metabolized, and eliminated by the body. The following parameters can describe the pharmacokinetics of foscarnet.
Absorption
The peak plasma concentration is 589 µM (60 mg/kg every 8 hours) and 623 µM (90 mg/kg every 12 hours)
Distribution
The volume of distribution is 0.41 L/kg for (60 mg/kg every 8 hours) and 0.52 L/kg for (90 mg/kg every 12 hours).
The bound protein is 14-17%
Metabolism
The drug is not metabolized.
Elimination and excretion
Half-life is 4 hours (60 mg/kg every 8 hours) and 3.3 hours (90 mg/kg every 12 hours).
Administration:
Administer the medication following slow intravenous infusion.
To decrease the risk of nephrotoxicity, hydrate pre-hydrate with normal saline (750-1000 ml) before the first infusion.
Patient information leaflet
Generic Name: foscarnet
Pronounced: fos-kaar-net
Why do we use foscarnet?
foscarnet treats Herpes Simplex and CMV (Cytomegalovirus) Retinitis.
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