Intravenous Cytomegaloviral retinitis in AIDS patients
Adult: Induction: 60 mg/kg given via infusion over 1 hour, every 8 hours for 2-3 weeks. Maintenance: 60 mg/kg once daily, increase to 90-120 mg/kg once daily if tolerated. If progression occurs, re-treat with induction regimen.
This drug may cause dizziness, if affected, do not drive or operate machinery.
Monitor ECG, 24-hour creatinine clearance, electrolytes at baseline and periodically thereafter. Monitor complete blood count, electrolytes (e.g. Mg, Ca, K, phosphorus) twice weekly during induction stage and once weekly during maintenance therapy. Check hydration status before administration.
Symptoms: Seizures, renal impairment, paraesthesias, electrolyte disturbances. Management: Haemodialysis and hydration may be of benefit.
May enhance nephrotoxic effect with aminoglycosides, amphotericin B, ciclosporin, aciclovir, methotrexate and tacrolimus. Increased risk of QT prolongation with antiarrhythmic agents (e.g. quinidine, amiodarone, sotalol).
Description: Foscarnet sodium is a non-nucleoside pyrophoshate analogue which acts as a noncompetitive inihibitor of many viral RNA and DNA polymerases as well as HIV reverse transcriptase. Pharmacokinetics: Distribution: Volume of distribution: Approx 0.5 L/kg. Plasma protein binding: Approx 14% to 17%. Excretion: Via urine (≤28% as unchanged drug). Elimination half-life: Approx 3 to 4 hours.