Comparative Pharmacology
Head-to-head clinical analysis: FOSCARNET SODIUM versus HARVONI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FOSCARNET SODIUM versus HARVONI.
FOSCARNET SODIUM vs HARVONI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Foscarnet is an organic analog of inorganic pyrophosphate that selectively inhibits the DNA polymerase activity of herpesviruses, including cytomegalovirus (CMV) and herpes simplex virus (HSV), at the pyrophosphate binding site without requiring activation by thymidine kinase. It also inhibits HIV reverse transcriptase.
Fixed-dose combination of ledipasvir, an HCV NS5A inhibitor, and sofosbuvir, an HCV NS5B nucleotide polymerase inhibitor. Ledipasvir inhibits HCV NS5A protein essential for viral replication and assembly; sofosbuvir is a prodrug that after intracellular metabolism acts as a chain terminator by inhibiting NS5B RNA-dependent RNA polymerase.
Induction: 60 mg/kg IV every 8 hours for 14–21 days, followed by maintenance: 90–120 mg/kg IV once daily. Infuse at no more than 1 mg/kg/min via central or peripheral line.
One tablet (90 mg ledipasvir/400 mg sofosbuvir) orally once daily with or without food for 12 weeks. For treatment-naïve patients with genotype 1 and cirrhosis, 24 weeks may be considered. For genotype 4, 12 weeks recommended.
None Documented
None Documented
Terminal elimination half-life is approximately 48 hours (range 24-88 hours), reflecting prolonged intracellular retention; clinical context necessitates dose adjustment for renal impairment and monitoring of renal function.
Ledipasvir: 47 hours; Sofosbuvir: 0.5 hours; GS-331007 (predominant circulating metabolite): 27 hours; clinical context: supports once-daily dosing with no accumulation beyond steady state by day 7
Primarily excreted unchanged by the kidney via glomerular filtration and tubular secretion; >80% of dose recovered in urine within 24 hours; minimal biliary or fecal excretion (<5%).
Ledipasvir: 86% fecal, 1% renal; Sofosbuvir: 80% renal (as inactive metabolite GS-331007), 14% fecal; GS-331007: 78% renal
Category A/B
Category C
Antiviral
Antiviral