Comparative Pharmacology
Head-to-head clinical analysis: FOSCAVIR versus GANCICLOVIR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FOSCAVIR versus GANCICLOVIR.
FOSCAVIR vs GANCICLOVIR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Foscarnet is a pyrophosphate analog that selectively inhibits viral DNA polymerase and reverse transcriptase by binding to the pyrophosphate binding site, preventing the cleavage of pyrophosphate from deoxynucleotide triphosphates, thereby inhibiting viral DNA synthesis. It does not require activation by viral thymidine kinase, making it active against acyclovir-resistant HSV and VZV, and ganciclovir-resistant CMV.
Ganciclovir is a synthetic guanine nucleoside analog that inhibits viral DNA synthesis by competitively inhibiting viral DNA polymerase and by incorporating into viral DNA, causing chain termination. It requires initial phosphorylation by viral thymidine kinase (CMV) or protein kinase (HSV).
Induction: 60 mg/kg IV every 8 hours for 2-3 weeks, then maintenance: 90-120 mg/kg IV once daily. Administer as a 2-hour infusion via central line.
Induction: 5 mg/kg IV every 12 hours for 14-21 days. Maintenance: 5 mg/kg IV every 24 hours. Oral: 1000 mg three times daily with food.
None Documented
None Documented
Clinical Note
moderateGanciclovir + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Ganciclovir."
Clinical Note
moderateValganciclovir + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Valganciclovir."
Clinical Note
moderateGanciclovir + Mycophenolic acid
"The serum concentration of Mycophenolic acid can be increased when it is combined with Ganciclovir."
Clinical Note
moderateValganciclovir + Mycophenolic acid
Terminal elimination half-life is approximately 3-5 hours in patients with normal renal function; can extend to 48-120 hours in severe renal impairment (CrCl <20 mL/min), requiring dose adjustment and therapeutic drug monitoring.
Terminal half-life: 2.5-5.0 hours in normal renal function; prolonged to 10-30 hours in renal impairment; requires dose adjustment for CrCl <70 mL/min
Primarily renal excretion (>80% as unchanged drug) via glomerular filtration and tubular secretion; minimal biliary/fecal elimination (<5%).
Renal excretion: >90% unchanged; biliary/fecal: minimal (<5%)
Category C
Category D/X
Antiviral
Antiviral
"The serum concentration of Mycophenolic acid can be increased when it is combined with Valganciclovir."