Comparative Pharmacology
Head-to-head clinical analysis: FOSCAVIR versus ZOVIRAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FOSCAVIR versus ZOVIRAX.
FOSCAVIR vs ZOVIRAX
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.
After intracellular phosphorylation to acyclovir triphosphate, selectively inhibits viral DNA polymerase and incorporates into viral DNA, causing chain termination.
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.
Herpes simplex: 200 mg orally 5 times daily for 10 days; or 400 mg orally 3 times daily for 5-10 days. Herpes zoster: 800 mg orally 5 times daily for 7-10 days. IV: 5-10 mg/kg every 8 hours for immunocompromised patients with HSV/VZV.
None Documented
None Documented
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 elimination half-life is 2.5-3.3 hours in adults with normal renal function; prolonged to 19.5 hours in anuria (creatinine clearance <10 mL/min).
Primarily renal excretion (>80% as unchanged drug) via glomerular filtration and tubular secretion; minimal biliary/fecal elimination (<5%).
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 76-82% of elimination; fecal excretion is less than 2%.
Category C
Category C
Antiviral
Antiviral