1. Minimising the Dosage-Limiting Toxicities of Foscarnet Induction Therapy
  2. Journal of Transplantation
  4. Foscarnet Sodium | FDA Label - Injection (solution) | AIDSinfo

of FOSCAVIR contains 24 mg of foscarnet sodium hexahydrate in Water for Sensitivity test results, expressed as the concentration of drug required to inhibit by. PHARMACOLOGY. Foscarnet is an antiviral agent with a broad antiviral spectrum which inhibits all known human viruses of the herpes group (Herpes simplex. The dose of foscarnet should be adjusted to the renal function as assessed by .. the dose of the drug used had not been promptly adjusted for a patient.

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Foscarnet Package Insert Pdf

Package leaflet: Information for the user. Foscavir®. 24 mg/ml Solution for Infusion foscarnet. M/06 UK. Read all of this leaflet carefully before you start. Nephrotoxicity is the major toxicity associated with foscarnet therapy; the majority of drug recipients will experience a decline in renal function during therapy. See full prescribing information for complete boxed warning. for amino acid substitutions selected in cell culture by ganciclovir, cidofovir or foscarnet.

Foscarnet trisodium phosphonoformate has been used for the treatment of CMV disease in patients who are infected with HIV. Some physicians who treat patients with CMV infection are reluctant to use foscarnet because of the serious adverse effects that may occur, especially during the induction period. The most frequently reported serious adverse effects are nephrotoxicity, electrolyte disturbances, nausea, penile ulcerations and seizures. The nephrotoxicity associated with foscarnet is attributable to renal tubular damage, and may be minimised by calculating and infusing the appropriate dose after hydrating the patient. Monitoring serum electrolyte levels and replacing electrolytes before symptoms occur may limit the development of dosage-limiting toxicities. Nausea occurring during foscarnet infusions may be ameliorated by using antiemetics and slowing the infusion rate. Seizures associated with the use of this agent are mostly a result of the simultaneous presence of other CNS pathologies.

In the case of poor therapeutic response, sensitivity testing of the viral isolate also is advised. Patients who experience seizures, dizziness, somnolence or other adverse reactions that could result in impairment, should be advised to avoid driving or operating machinery.

General: Patients should be informed that the major toxicities of foscarnet are renal impairment, electrolyte disturbances, and seizures, and that dose modifications and possibly discontinuation may be required. The importance of close monitoring while on therapy must be emphasized. Patients should be advised of the importance of reporting to their physicians symptoms of perioral tingling, numbness in the extremities or paresthesias during or after infusion as possible symptoms of electrolyte abnormalities.

Minimising the Dosage-Limiting Toxicities of Foscarnet Induction Therapy

Patients should also be advised to promptly report any cardiac symptoms. Should such symptoms occur, the infusion of FOSCAVIR should be stopped, appropriate laboratory samples for assessment of electrolyte concentrations obtained, and a physician consulted before resuming treatment.

The potential for renal impairment may be minimized by accompanying FOSCAVIR administration with hydration adequate to establish and maintain a diuresis during dosing. Toxicity associated with concomitant use of aerosolized pentamidine has not been reported. Because FOSCAVIR can reduce serum levels of ionized calcium, extreme caution is advised when used concurrently with other drugs known to influence serum calcium levels e. Because of foscarnet's tendency to cause renal impairment, the use of FOSCAVIR should be avoided in combination with potentially nephrotoxic drugs such as aminoglycosides, amphotericin B, cyclosporine, acyclovir, methotrexate, tacrolimus and intravenous pentamidine see above unless the potential benefits outweigh the risks to the patient.

Journal of Transplantation

When diuretics are indicated, thiazides are recommended over loop diuretics because the latter inhibit renal tubular secretion, and may impair elimination of FOSCAVIR, potentially leading to toxicity. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

The results of peri- and post-natal studies in rats were also negative. However, these studies used exposures that are inadequate to define the potential for impairment of fertility at human drug exposure levels. These studies are inadequate to define the potential teratogenicity at levels to which women will be exposed.

Because of the potential for serious adverse events in nursing infants, a decision should be made whether to discontinue nursing or discontinue drug, taking into consideration the importance of the drug to the mother. The effects of this deposition on skeletal development have not been studied. This is so that you have the dose that is right for you.

Sometimes your doctor may ask you to have a medicine called ganciclovir as well.


This is to make sure that you have the treatment that is right for you. However, you may need to keep having Foscavir for 2 to 3 weeks or until your wounds have healed.

Wash your genitals carefully after passing water urine. This will help to prevent any sores from developing. If you get Foscavir solution on your skin or in your eyes If you get Foscavir solution on your skin or in your eyes by mistake, rinse your skin or your eyes straight away with water.

Pre-treatment with hydration and electrolytes may prevent dose limiting toxicities during foscarnet induction therapy. Gentourin Med ; —5 Google Scholar Reversible acute renal failure caused by the combined use of foscarnet and cyclosporin in organ transplanted patients [letter].

Foscarnet-induced changes in plasma calcium and magnesium in HIV seropositive patients. Antiviral Ther ; 1 3 : —9 Google Scholar Foscarnet-induced hypocalcemia and effects of foscarnet on calcium metabolism. Severe hypocalcemia in AIDS patients treated with foscarnet and pentamidine [letter]. Foscarnet-induced severe hypomagnesemia and other electrolyte disorders.

Mechanism of phosphaturia elicited by administration of phosphonoformate in vivo. Am J Physiol ; —10 Google Scholar Lor E, Liu YQ. Neurological sequelae associated with foscarnet therapy.

A penile ulceration in a patient with the acquired immunodeficiency syndrome. Arch Dermatol ; —52 Google Scholar Penile ulcerations with foscarnet therapy.

Foscarnet Sodium | FDA Label - Injection (solution) | AIDSinfo

Foscarnet-induced vulval erosion [letter]. Foscarnet and penile ulceration [letter].

Lancet ; CrossRef Google Scholar Encapsulation of foscarnet in liposomes modifies drug intracellular accumulation, in vitro anti-HIV-1 activity, tissue distribution and pharmacokinetics. Increased efficacy of ganciclovir and foscarnet inhibition of cytomegalovirus replication in vitro by encapsulation in liposomes.

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