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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