Foscarnet

Foscarnet Brand Name– Foscavir

What is Foscarnet

Foscarnet is an intravenous antiviral agent.

It is an organic analog of inorganic pyrophosphate, and it is structurally unrelated to other antiviral agents.

Foscarnet was first synthesized in the 1920s. Almost 60 years later, it was found to inhibit influenza virus RNA polymerase. This led to investigation of foscarnet for potential activity against herpes simplex virus types 1 and 2 and against cytomegalovirus.

Foscarnet is currently indicated for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome (AIDS). It is also being investigated for treatment of cytomegalovirus disease, herpes simplex, and varicella-zoster infection in HIV-infected patients.

Unlike ganciclovir, foscarnet is not associated with major myelosuppressive toxicity and does not require phosphorylation before it becomes activated.

Foscarnet was approved by the FDA in September 1991 for treatment of CMV-retinitis.

In July 1995, the FDA also approved foscarnet for treatment of acyclovir-resistant mucocutaneous herpes simplex.

Indications

1. cytomegalovirus (CMV)
2. cytomegalovirus (CMV) disease prophylaxis
3. cytomegalovirus (CMV) pneumonitis
4. cytomegalovirus (CMV) retinitis
5. cytomegalovirus (CMV) retinitis prophylaxis
6. cytomegalovirus (CMV)-associated gastrointestinal disease
7. encephalitis
8. herpes genitalis
9. herpes labialis
10. herpes simplex virus infection
11. herpes simplex virus type 1
12. herpes simplex virus type 2
13. herpes zoster (shingles) infection
14. human herpesvirus 6 (HHV-6)
15. human herpesvirus 6 (HHV-6) infection
16. progressive outer retinal necrosis (PORN)
17. varicella-zoster virus

Side Effects

1. abdominal pain
2. agitation
3. amnesia
4. anaphylactic shock
5. anaphylactoid reactions
6. anemia
7. angioedema
8. anorexia
9. anxiety
10. aphasia
11. arthralgia
12. asthenia
13. ataxia
14. AV block
15. back pain
16. bronchospasm
17. bullous rash
18. candidiasis
19. cardiac arrest
20. chest pain (unspecified)
21. coma
22. confusion
23. conjunctivitis
24. constipation
25. cough
26. dehydration
27. depression
28. diabetes insipidus
29. diaphoresis
30. diarrhea
31. dizziness
32. drowsiness
33. dysgeusia
34. dyspepsia
35. dysphagia
36. dyspnea
37. edema
38. elevated hepatic enzymes
39. erythema
40. erythema multiforme
41. esophageal ulceration
42. Fanconi syndrome
43. fatigue
44. fever
45. flatulence
46. flushing
47. GI bleeding
48. glomerulonephritis
49. hallucinations
50. headache
51. hematuria
52. hemoptysis
53. hyperphosphatemia
54. hypertension
55. hypocalcemia
56. hypoesthesia
57. hypokalemia
58. hypomagnesemia
59. hyponatremia
60. hypophosphatemia
61. hypotension
62. infection
63. influenza
64. injection site reaction
65. insomnia
66. leukopenia
67. lymphadenopathy
68. maculopapular rash
69. malaise
70. melena
71. meningitis
72. muscle cramps
73. myalgia
74. myopathy
75. nausea
76. nephrotic syndrome
77. nephrotoxicity
78. neutropenia
79. nocturia
80. ocular pain
81. pancreatitis
82. pancytopenia
83. paresthesias
84. peripheral neuropathy
85. pharyngitis
86. pneumothorax
87. proteinuria
88. pruritus
89. QT prolongation
90. rash
91. renal failure (unspecified)
92. renal tubular acidosis (RTA)
93. renal tubular necrosis
94. rhabdomyolysis
95. rhinitis
96. seborrhea
97. seizures
98. SIADH
99. sinus tachycardia
100. sinusitis
101. skin discoloration
102. skin ulcer
103. ST-T wave changes
104. Stevens-Johnson syndrome
105. stomatitis
106. thrombocytopenia
107. thrombosis
108. torsade de pointes
109. toxic epidermal necrolysis
110. tremor
111. urticaria
112. vesicular rash
113. vomiting
114. weakness
115. weight loss
116. xerostomia

Monitoring Parameters

• CBC
• ECG
• ophthalmologic exam
• serum creatinine/BUN
• serum electrolytes

Contraindications

• anemia
• apheresis
• AV block
• bradycardia
• breast-feeding
• cardiac disease
• cardiomyopathy
• celiac disease
• dehydration
• driving or operating machinery
• electrolyte imbalance
• females
• fever
• geriatric
• heart failure
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypothermia
• hypothyroidism
• infusion-related reactions
• long QT syndrome
• myocardial infarction
• nephrotoxicity
• neurological disease
• neutropenia
• pheochromocytoma
• pregnancy
• QT prolongation
• renal failure
• renal impairment
• rheumatoid arthritis
• seizure disorder
• seizures
• sickle cell disease
• sleep deprivation
• sodium restriction
• stroke
• systemic lupus erythematosus (SLE)

Interactions

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