Foscarnet

Excreted Unchanged %
85
Half-Life (Normalesrd) Hours
3/Prolonged (up to 100)
Plasma Protein Binding %
17
Volume Of Distribution L/Kg
0.3-0.6
Dose For Normal Renal Function
40-60 mg/kg q8h
Second Dose
Second Dose: to 90 mg/kg q12h (depends on indication)
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
28 mg/kg [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
15 mg/kg[A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
6 mg/kg[A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: CMV induct: 60 mg q24h; CMV main: 60 mg q48h, [B]
References
Alexander AC, Akers A, Matzke GR, Aweeka FT, Fraley DS. Disposition of foscarnet during peritoneal dialysis. Ann Pharmacother. 1996; 30: 1106-9. [PMID: 8893116] / Aweeka FT, Jacobson MA, Martin-Munley S, Hedman A, Schoenfeld P, Omachi R, et al. Effect of renal disease and hemodialysis on foscarnet pharmacokinetics and dosing recommendations. J Acquir Immune Defic Syndr Hum Retrovirol. 1999; 20: 350-7. [PMID: 10096579] / Aweeka FT, Pirrung D, Lizak P, et al. Pharmacokinetics of foscarnet in patients with varying degrees of renal function and hemodialysis [Abstract]. Clin Pharmacol Ther. 1994; 55: 195. [PMID unavailable] / MacGregor RR, Graziani AL, Weiss R, Grunwald JE, Gambertoglio JG. Successful foscarnet therapy for cytomegalovirus retinitis in an AIDS patient undergoing hemodialysis: rationale for empiric dosing and plasma level monitoring. J Infect Dis. 1991; 164: 785-7. [PMID: 1654363] / Sam R, Patel SB, Popli A, Leehey DJ, Gambertoglio JG, Ing TS. Removal of Fos-carnet by hemodialysis using dialysate-side values. Int J Artif Organs. 2000; 23: 165-7.[PMID: 10795660]
Toxicity Notes
Nephrotoxic. Seizures, hypokalemia, hypocalcemia, hypomagnesemia.