Infusion: 24 mg/ml (250 ml, 500 ml)
foscarnet cream (2%) Unlicensed in UK, available from special order manufacturers
CMV retinitis infection:
Induction treatment: 90 mg/kg IV 12 hourly for 14–21 days.
Initiate at 60 mg/kg IV once a day and if tolerated increase to 90–120 mg/kg IV once a day.
Exact doses depend on renal function
Direct intraocular injection:
Usual injection prepared as 2400 mg/0.1ml (0.05ml injected). Injection frequency varied according to response
CMV colitis, oesophagitis:
Second line after ganciclovir
foscarnet IV 90 mg/kg twice a day for 14–28 days
Resistant herpes simplex infection:
40 mg/kg IV 8–12 hourly for 2–3 weeks until healing
Progressive outer retinal necrosis (PORN):
aciclovir 10 mg/kg IV three times a day with foscarnet 90 mg/kg IV twice a day
Renal toxicity; electrolyte disturbances (hypokalaemia, hypocalcaemia, (especially if used in conjunction with IV pentamidine) hypomagnesaemia);
genital ulceration; abnormal LFTs; thrombophlebitis; anaemia; gastrointestinal disturbances; peripheral tingling; seizures; tremor; confusion
Addition hydration oral or IV
Irritation or genital ulceration can be prevented by ensuring careful washing of the genital area after micturation
Additive toxicity with other nephrotoxic drugs e.g. aminoglycosides, amphotericin, IV pentamidine. Use with extreme caution
See SmPC for dosage reduction according to creatinine clearance
Monitor renal function every second day during induction and weekly during maintenance
No dosage reduction required.
Compatible – Maternal Benefit >> Embryo-Foetal Risk