Foscarnet Availability
Foscarnet is FDA-approved and commercially available in most developed countries including the United States, Canada, Europe, and many other regions worldwide, though access requires hospital-based or specialty infusion center coordination rather than retail pharmacy availability. 1
How to Access Foscarnet in Your Location
Hospital-Based Access (Primary Route)
- Contact your hospital pharmacy directly to confirm formulary status and ordering procedures, as foscarnet is typically a non-formulary or restricted medication requiring infectious disease consultation 1
- Foscarnet requires IV administration over 1-2 hours with mandatory hydration protocols and close monitoring for nephrotoxicity and electrolyte disturbances, making hospital-based delivery the standard approach 1
- The medication is not stocked in retail pharmacies due to these intensive administration and monitoring requirements 1
Outpatient Infusion Centers
- Outpatient infusion centers can provide foscarnet therapy for maintenance regimens, though this requires coordination with specialty pharmacies and home health services 1
- Twice-weekly creatinine and electrolyte monitoring is mandatory, which must be arranged through the infusion center 1
Insurance Authorization Requirements
- Prior authorization is typically required given the high cost (approximately $27,960-$36,770 annually for maintenance therapy) 1
- Authorization usually necessitates documentation of ganciclovir resistance, intolerance, or contraindication 1
- Verify insurance coverage before initiating therapy, as most insurance plans require pre-authorization due to high cost and specialized monitoring requirements 1
Regional Availability Patterns
Developed Healthcare Systems
- Consistent access is maintained through hospital formularies and specialty pharmacies in the US, Canada, EU, Australia, and Japan 1
- The medication is FDA-approved in the United States and available through established pharmaceutical distribution channels 1
Resource-Limited Settings
- Access may be restricted due to cost, cold-chain storage requirements, and the need for intensive monitoring infrastructure 1
- The requirement for twice-weekly laboratory monitoring creates additional barriers in settings with limited healthcare infrastructure 1
Clinical Context for Use
Foscarnet is indicated as second-line therapy for:
- Acyclovir-resistant herpes simplex virus infections in HIV-infected patients, dosed at 40 mg/kg IV every 8 hours until clinical resolution 2
- Ganciclovir-resistant or intolerant CMV infections in immunocompromised patients, including transplant recipients 2
- CMV retinitis in AIDS patients when ganciclovir causes prohibitive myelosuppression 3
- Pre-emptive CMV therapy in hematopoietic stem cell transplant recipients who develop neutropenia on ganciclovir, dosed at 60 mg/kg IV twice daily 4, 5
The medication's nephrotoxic potential (affecting up to 30% of patients) and requirement for aggressive saline hydration necessitate the hospital-based or infusion center delivery model 2, 3