Drug General Information (ID: DDIH9DZA0U)
Drug Name			Foscarnet		Drug Info		Neomycin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Antibiotics
Structure

Mechanism of Foscarnet-Neomycin Interaction (Severity Level: Major)
Increased risk of hypocalcemia Click to Show/Hide Mechanism Graph
Drug Name		Foscarnet				Neomycin
Mechanism 1		Hypocalcemia				Hypocalcemia
Key Mechanism Factor 1
		Factor Name		Hypocalcemia
		Factor Description		Hypocalcemia is a low level of calcium found in a blood test. It can cause symptoms such as tingling, muscle cramps and heart rhythm problems that can range from mild to life-threatening.
Mechanism Description		Increased risk of hypocalcemia by the combination of Foscarnet and Neomycin
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Foscarnet				Neomycin
Mechanism 2		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 2
		Factor Name		Nephrotoxicity
		Factor Description		The combination of drugs that can induce nephrotoxicity may increase the risk of kidney injury. When kidney injury occurs, the inability to remove excess urine and waste from the body can lead to high levels of urea nitrogen, creatinine, and electrolytes (such as potassium and magnesium) in the blood.
Mechanism Description		Increased risk of nephrotoxicity by the combination of Foscarnet and Neomycin

Recommended Action
Management		The manufacturer recommends avoiding concomitant therapy unless the potential benefits outweigh the risks. Electrolyte levels and renal function of patients receiving these medications concomitantly should be monitored carefully, and dosages adjusted or discontinued if necessary.

References
1	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA.".
2	Blanshard C "Treatment of HIV-related cytomegalovirus disease of the gastrointestinal tract with foscarnet." J Acquir Immune Defic Syndr 5 (1992): s25-8. [PMID: 1318364]
3	Cacoub P, Deray G, Baumelou A, et al "Acute renal failure induced by foscarnet: 4 cases." Clin Nephrol 29 (1988): 315-8. [PMID: 2840226]
4	Cerner Multum, Inc "ANVISA Bulario Eletrnico.".
5	Cerner Multum, Inc. "Australian Product Information.".
6	Cerner Multum, Inc. "Canadian Product Information.".
7	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
8	Cotte L, Langlois M, Trepo C "Herpes simplex virus infection during foscarnet therapy." J Infect Dis 166 (1992): 447-8. [PMID: 1321865]
9	Deray G, Katlama C, Dohin E "Prevention of foscarnet nephrotoxicity." Ann Intern Med 113 (1990): 332. [PMID: 2165372]
10	Deray G, Le Hoang P, Soubrie C, et al "Foscarnet-induced acute renal failure and effectiveness of haemodialysis." Lancet 2 (1987): 216. [PMID: 2885666]
11	Deray G, Martinez F, Katlama C, et al "Foscarnet nephrotoxicity: mechanism, incidence and prevention." Am J Nephrol 9 (1989): 316-21. [PMID: 2554731]
12	Farese RV Jr, Schambelan M, Hollander H, et al "Nephrogenic diabetes insipidus associated with foscarnet treatment of cytomegalovirus retinitis." Ann Intern Med 112 (1990): 955-6. [PMID: 2160217]
13	Jacobson MA "Review of the toxicities of foscarnet." J Acquir Immune Defic Syndr 5 (1992): s11-7. [PMID: 1534839]
14	Palestine AG, Polis MA, De Smet MD, et al "A randomized, controlled trial of foscarnet in the treatment of cytomegalovirus retinitis in patients with AIDS." Ann Intern Med 115 (1991): 665-73. [PMID: 1656826]
15	Product Information. Amikin (amikacin). Bristol-Myers Squibb, Princeton, NJ.
16	Product Information. Arikayce (amikacin liposome). Insmed Incorporated, Bridgewater, NJ.
17	Product Information. Foscavir (foscarnet). Astra USA, Westborough, MA.
18	Product Information. Gentamicin Sulfate, Injectable (gentamicin). Fresenius Kabi USA, LLC, Lake Zurich, IL.
19	Ringden O, Lonnqvist B, Paulin T, et al "Pharmacokinetics, safety and preliminary clinical experiences using foscarnet in the treatment of cytomegalovirus infections in bone marrow and renal transplant recipients." J Antimicrob Chemother 17 (1986): 373-87. [PMID: 3009383]
20	SOCA Reseach Group, et al "Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis." N Engl J Med 326 (1992): 213-20. [PMID: 1345799]
21	Willocks L, Brettle R "Foscarnet and pancytopenia." J Antimicrob Chemother 29 (1992): 232. [PMID: 1387130]