Foscarnet sodium


Thông tin thuốc gốc
Chỉ định và Liều dùng
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.

Intravenous
Aciclovir-resistant mucocutaneous herpes simplex virus infection
Adult: In immunocompromised patients: 40 mg/kg via infusion over 1 hour, every 8 hours for 2-3 weeks or until lesions heal.
Renal Impairment
Cytomegaloviral retinitis in AIDS patients
CrCl (mL/kg/min) Dosage
<0.4 Not recommended.
0.4-0.6 Induction: 21 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
0.6-0.8 Induction: 28 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
0.8-1.0 Induction: 35 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
1.0-1.2 Induction: 42 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
1.2-1.4 Induction: 49 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
1.4-1.6 Induction: 55 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.
>1.6 Induction: 60 mg/kg via infusion over 1 hour, every 8 hours. Maintenance: Same with induction dosage, to be given once daily.

Aciclovir-resistant mucocutaneous herpes simplex virus infections

CrCl (mL/kg/min) Dosage
0.4-0.6 14 mg/kg via infusion over 1 hour, every 8 hours.
0.6-0.8 19 mg/kg via infusion over 1 hour, every 8 hours.
0.8-1.0 24 mg/kg via infusion over 1 hour, every 8 hours.
1.0-1.2 28 mg/kg via infusion over 1 hour, every 8 hours.
1.2-1.4 33 mg/kg via infusion over 1 hour, every 8 hours.
1.4-1.6 37 mg/kg via infusion over 1 hour, every 8 hours.
>1.6 40 mg/kg via infusion over 1 hour, every 8 hours.
Hướng dẫn pha thuốc
Dilute with equal amount of dextrose in water 5% or NaCl 0.9% inj to provide a solution containing 12 mg/mL.
Chống chỉ định
Lactation.
Thận trọng
Patient with electrolyte imbalance, neurologic or cardiac abnormalities, heart failure, history or risk of QT prolongation, risk factors for seizures. Renal impairment. Pregnancy.
Phản ứng phụ
Significant: Electrolyte imbalance (e.g. hypokalaemia, hypocalcaemia, hypomagnesaemia, hyper/hypophosphataemia), anaemia, granulocytopaenia, QT prolongation, seizures, serious hypersensitivity reactions (e.g. anaphylactic shock, angioedema).
Blood and lymphatic system disorders: Thrombocytopenia, neutropenia, leucopenia, bone marrow suppression.
Eye disorders: Visual disturbance.
Gastrointestinal disorders: Diarrhoea, nausea, vomiting, abdominal pain.
General disorders and administration site conditions: Fever, weakness, asthenia, chills, malaise, fatigue.
Injury, poisoning and procedural complications: Injection site reactions.
Investigations: Blood creatinine increased, haemoglobin decreased, electrocardiogram abnormal, decreased creatinine clearance.
Metabolism and nutrition disorders: Decreased appetite.
Musculoskeletal and connective tissue disorders: Muscle spasm.
Nervous system disorders: Headache, dizziness, paraesthesia, hypoaesthesia, peripheral neuropathy, rigors/tremor.
Psychiatric disorders: Anxiety, depression, aggression, agitation.
Renal and urinary disorders: Nephrotoxicity.
Respiratory, thoracic and mediastinal disorders: Cough, dyspnoea.
Skin and subcutaneous tissue disorders: Rash, diaphoresis, pruritus.
Potentially Fatal: Renal impairment.
IV/Parenteral: C
Thông tin tư vấn bệnh nhân
This drug may cause dizziness, if affected, do not drive or operate machinery.
MonitoringParameters
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.
Quá liều
Symptoms: Seizures, renal impairment, paraesthesias, electrolyte disturbances. Management: Haemodialysis and hydration may be of benefit.
Tương tác
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).
Tác dụng
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.
Đặc tính

Chemical Structure Image
Foscarnet sodium

Source: National Center for Biotechnology Information. PubChem Database. Foscarnet sodium, CID=44561, https://pubchem.ncbi.nlm.nih.gov/compound/Foscarnet-sodium (accessed on Jan. 21, 2020)

Bảo quản
Store between 20-25°C. Do not refrigerate.
Phân loại MIMS
Phân loại ATC
J05AD01 - foscarnet ; Belongs to the class of phosphonic acid derivative antivirals. Used in the systemic treatment of viral infections.
References
Anon. Foscarnet. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/05/2018.

Buckingham R (ed). Foscarnet Sodium. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/05/2018.

Foscavir Injection (Astrazeneca LP). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/05/2018.

Joint Formulary Committee. Foscarnet Sodium. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/05/2018.

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