Foscarnet (phosphonomethanoic acid), known by its brand name Foscavir, is an antiviral medication which is primarily used to treat viral infections involving the Herpesviridae family. It is classified as a pyrophosphate analog DNA polymerase inhibitor.
Foscarnet was approved for medical use in 1991.
Medical use
This
phosphonic acid derivative (marketed by
Clinigen as foscarnet
sodium under the trade name Foscavir) is an antiviral medication used to treat
Herpesviridae, including drug-resistant
cytomegalovirus (CMV) and
herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2). It is particularly used to treat
CMV retinitis. Foscarnet can be used to treat highly treatment-experienced patients with
HIV as part of
salvage therapy.
Mechanism of action
Foscarnet is a structural mimic of the anion
pyrophosphate that selectively inhibits the pyrophosphate binding site on viral
at
that do not affect human DNA polymerases.
In individuals treated with the DNA polymerase inhibitors acyclovir or ganciclovir, HSV or CMV particles can develop mutant protein kinases (thymidine kinase or UL97 protein kinase, respectively) that make them resistant to these antiviral drugs.
However, acyclovir- or ganciclovir-resistant mutants with alterations in viral DNA polymerase may also be resistant to foscarnet.
Administration
Foscarnet is administered by
intravenous infusion or intravitreous injection.
Side effects
-
Nephrotoxicity — increase in serum creatinine levels and renal injury can occur in patients receiving foscarnet.
-
Electrolyte disturbances — hypocalcemia and hypomagnesemia can occur
-
Genital ulceration — a less common reported side effect which occurs more in men and usually during induction use of foscarnet.
-
CNS — less common side effects of perioral paresthesia, irritability and altered mental states.
Sources
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