Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Original Date: 
November 2007
Revised Date: 
June 2015
  • Alternative to ganciclovir for treatment of Cytomegalovirus (CMV) infections
  • Treatment of CMV retinitis in patients with acquired immunodeficiency syndrome;
  • Treatment of acyclovir-resistant mucocutaneous herpes simplex virus infections in immunocompromised patients and acyclovir-resistant herpes zoster infections
Reconstitution and Stability: 
  • Stable in NS or D5W at 12 mg/mL for 35 days at room temperature
  • Available as 24 mg/mL solution (250 mL or 500 mL).

- Solutions Compatible:  D5W , NS 

 - Y-site or additives: because of multiple interactions foscarnet should not be added or administered with any other drugs. Contact pharmacy as required


 Incompatible: Acyclovir, amphotericin B, cotrimoxazole (septra), dextrose 30%, diphenhydramine, ganciclovir, leucovorin, midazolam, pentamidine, prochlorperazine, vancomycin, TPN or solutions containing calcium and magnesium (and more; contact pharmacy).


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct NO
IV Intermittent Infusion YES,

Usual dilution:  12 mg/mL

Infusion time is dose dependent: 

less than and equal to 60 mg/kg/dose: infuse over at least 1 hour

greater than 60 mg/kg/dose: infuse over at least 2 hours

IV Continuous Infusion NO





(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Adult and Pediatric

CMV retinitis:

·         Induction: 60 mg/kg IV Q8H over 60-90 minutes or 90 mg/kg IV Q12H over 2 hours for 14-21 days

·         Maintenance: 90-120 mg/kg/day IV over 2 hours


CMV infection of GI tract:

·         90 mg/kg IV Q12H over 2 hours


Acyclovir resistant herpes simplex virus infection (treatment for up to 3 weeks)

·         40 mg/kg IV Q8H over 1 hour or 40-60 mg/kg IV Q12H


Dosage should be adjusted in patients with renal dysfunction. Refer to manufacturer information.

Potential hazards of parenteral administration: 
  • Renal function impairment.
  • Hypocalcemia, hypo / hyper phosphatemia, hypomagnesemia, hypokalemia.
  • Anemia.
  • Seizures.
  • Erythema and thrombophebitis, if administered undiluted in peripheral veins.
  • Nausea, vomiting, fever, chills, fatigue, headache.
  • Paresthesias, rash.
  • Adjust dose for patients with renal impairment.
  • Adequate hydration is recommended during treatment to minimize renal toxicity. We recommend 500 mL/m2 pre-dose (adults: 750-1000 mL) and 500mL/m2 during infusion (adults: 500 mL for 40-60 mg/kg dosing & 750-1000 mL for 90-120 mg/kg dosing).
  • Monitor: serum creatinine, BUN, electrolytes, calcium, magnesium, phosphorus CBC, urine output, ophthalmologic exams.
  • Drug interactions: pentamidine (additive hypocalcemia); cyclosporine, aminoglycosides, amphotericin B (additive nephrotoxicity); ciprofloxacin (incease seizure potential).

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.