Nephrotoxicity; Seizure Risk
- 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 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.
- 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
Updated January 2018