- 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
- 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.)
| SC | NO |
| IM | NO |
| 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.
- 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).