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foscarnet (Intravenous route)

fos-KAR-net

Intravenous route(Solution)

The major toxicity of foscarnet sodium is renal impairment; therefore, frequent monitoring of serum creatinine, dose adjustment after renal function changes, and adequate hydration is necessary. Seizures related to plasma minerals and electrolyte alterations may occur. Monitor for changes and use mineral and electrolyte supplementation if necessary. Foscarnet sodium should only be used in immunocompromised patients with cytomegalovirus retinitis and mucocutaneous acyclovir-resistant herpes simplex virus infections .

Commonly used brand name(s)

In the U.S.

  • Foscavir

Available Dosage Forms:

  • Solution

Therapeutic Class: Antiviral

Pharmacologic Class: Viral DNA Polymerase Inhibitor

Uses For foscarnet

Foscarnet injection is used to treat symptoms of cytomegalovirus (CMV) infection of the eyes in patients with acquired immune deficiency syndrome (AIDS). Foscarnet will not cure CMV eye infection, but it may help to control worsening of the symptoms. foscarnet is also used to treat herpes simplex virus (HSV) infections of the skin and mucous membranes in people who are immunocompromised and whose infections did not improve with other treatment. Foscarnet may also be used for other serious viral infections as determined by your doctor. However, it does not work in treating certain viruses, such as the common cold or the flu.

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foscarnet is to be given only by or under the direct supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, foscarnet is used in certain patients with the following medical conditions:

  • Cytomegalovirus infections in places other than the eyes, such as the lungs, esophagus, or intestines.
  • Varicella-zoster infection (shingles) that does not respond to treatment with acyclovir in patients with HIV infection.

Before Using foscarnet

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For foscarnet, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to foscarnet or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of foscarnet injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of foscarnet injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving foscarnet injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving foscarnet, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using foscarnet with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Arsenic Trioxide
  • Bepridil
  • Cisapride
  • Dronedarone
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Probucol
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using foscarnet with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acyclovir
  • Ajmaline
  • Amikacin
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Amphotericin B
  • Anagrelide
  • Aprindine
  • Aripiprazole
  • Astemizole
  • Azimilide
  • Bretylium
  • Bumetanide
  • Buserelin
  • Capreomycin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cidofovir
  • Clarithromycin
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dibekacin
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Droperidol
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Ethacrynic Acid
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Framycetin
  • Furosemide
  • Gemifloxacin
  • Gentamicin
  • Gonadorelin
  • Goserelin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroquinidine
  • Hydroxychloroquine
  • Ibutilide
  • Imipramine
  • Isepamicin
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Kanamycin
  • Ketoconazole
  • Leuprolide
  • Lidoflazine
  • Lorcainide
  • Mefloquine
  • Methotrexate
  • Metronidazole
  • Moxifloxacin
  • Nafarelin
  • Neomycin
  • Netilmicin
  • Nortriptyline
  • Octreotide
  • Ondansetron
  • Panobinostat
  • Paromomycin
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Pirmenol
  • Prajmaline
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Risperidone
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Sisomicin
  • Sotalol
  • Spectinomycin
  • Spiramycin
  • Streptomycin
  • Sulfamethoxazole
  • Sultopride
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Tobramycin
  • Torsemide
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vasopressin
  • Vemurafenib
  • Vinflunine
  • Zolmitriptan
  • Zotepine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of foscarnet. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia or
  • Electrolyte or mineral imbalance (eg, low calcium, phosphorus, magnesium, or potassium) or
  • Granulocytopenia (a low number of certain white blood cells) or
  • Heart disease or
  • Seizures—Use with caution. May make these conditions worse.
  • Dehydration or
  • Kidney disease—May have an increased risk for more serious side effects.
  • Patients who are on a controlled sodium diet—Avoid foscarnet injection in patients with this condition.

Proper Use of foscarnet

A nurse or other health professional will give you foscarnet in a hospital. foscarnet is given through a needle placed in one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for at least 1 to 2 hours.

foscarnet may damage your kidneys. To help prevent this, you may have extra liquids given into your vein before or with your treatment. Your doctor may also want you to drink extra liquids while you are being given foscarnet.

To ensure the best response, foscarnet must be given for the full time of treatment. Also, foscarnet works best when there is a constant amount in the blood. To help keep the amount constant, foscarnet must be given on a regular schedule.

Precautions While Using foscarnet

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Do not breastfeed if you have HIV or AIDS, because you may give the infection to your baby through your breast milk.

foscarnet may cause sores on the genitals (sex organs). Washing your genitals after urination may decrease the chance of your developing this problem.

It is also very important that your ophthalmologist (eye doctor) check your eyes at regular visits since you may have some loss of eyesight due to retinitis even while you are receiving foscarnet injection.

foscarnet may make you dizzy. Do not drive or do anything else that could be dangerous until you know how foscarnet affects you.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

foscarnet Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Increased or decreased frequency of urination or amount of urine
  • increased thirst
Less common
  • Chills
  • convulsions
  • fever
  • muscle twitching
  • pain at place of injection
  • pain or numbness in hands or feet
  • tingling sensation around the mouth
  • tremor
  • unusual tiredness and weakness
Rare
  • Sores or ulcers on the mouth or throat, penis, or vulva

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Abdominal or stomach pain
  • anxious feeling
  • confusion
  • dizziness
  • headache
  • loss of appetite
  • nausea and vomiting
  • unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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