BlackBoxRX
 
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Foscarnet

Nephrotoxicity; Seizure Risk

Nephrotoxicity

  • Renal impairment is the major toxicity of foscarnet sodium injection.
  • Frequent monitoring of serum creatinine, with dose adjustment for changes in renal function, and adequate hydration with administration of foscarnet injection, is imperative.

Seizures

  • Seizures related to alterations in plasma minerals and electrolytes have been associated with foscarnet injection treatment.
  • Patients must be carefully monitored for such changes and their potential sequelae.
  • Mineral and electrolyte supplementation may be required.

Restricted Indications

  • For use only in immunosuppressed patients with CMV retinitis and mucocutaneous acyclovir resistant HSV infections.

MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA

  • Frequent serum creatinine monitoring with dose adjustments for changes in renal function and adequate hydration is essential.
  • Monitor plasma electrolytes and minerals.
  • Nephrotoxicity most likely to occur during second week of induction therapy but may occur anytime.
  • Hydration may reduce the risk of nephrotoxicity. A total of 750 to 100 mL of normal saline or 5% dextrose should be administered prior to first infusion to establish diuresis. Subsequent infusion instructions included in package insert.

Patient Counseling Information

Package Inserts

Foscarnet

Additional Information

Updated January 2018