Foscarnet

General information

Foscarnet (trisodium phosphonoformate hexahydrate) is a pyrophosphate analogue that interacts with the enzymatic action of polymerases and inhibits the cleavage of pyrophosphate from the nucleoside triphosphate. Because of this mechanism, the antiviral activity of the drug is broad. Foscarnet is a non-competitive inhibitor of herpesvirus DNA polymerase, hepatitis B virus DNA polymerase, and reverse transcriptases [ ]. Intravenous foscarnet has been used for the treatment of mucocutaneous disease due to aciclovir-resistant Herpes simplex [ ] and for the treatment of severe cytomegalovirus (CMV) infection [ , ]. Foscarnet is as effective as ganciclovir in the treatment of gastrointestinal CMV and CMV retinitis in patients with AIDS [ ]. However, the two drugs differ in their toxicity profiles, and in a comparison in CMV retinitis ganciclovir was better tolerated [ ]. Treatment-limiting adverse reactions are renal toxicity, hypocalcemia, and mucosal ulceration.

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