Foscarnet-Induced Severe Hypomagnesemia and other Electrolyte Disorders

Gearhart, Maureen O.; Sorg, Timothy B.

doi:10.1177/106002809302700304

Cited by 42 publications

(16 citation statements)

References 9 publications

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“…Foscarnet inhibits viral DNA polymerases by chelating divalent cations and, therefore, its use may cause hypomagnesemia (169). Patients also suffer from hypocalcemia and hypokalemia, which may be secondary to the Mg 2ϩ disturbances (253,369).…”

Section: Drug-induced Hypomagnesemiamentioning

confidence: 99%

Magnesium in Man: Implications for Health and Disease

Baaij

Hoenderop

Bindels

2015

Physiological Reviews

1,223

1,299

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Section: Drug-induced Hypomagnesemiamentioning

confidence: 99%

Magnesium in Man: Implications for Health and Disease

Baaij

Hoenderop

Bindels

2015

Physiological Reviews

1,223

1,299

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“…54 Other electrolyte disturbances include hypomagnesemia, hypokalemia, and hypo-or hyperphosphatemia. 55 …”

Section: Foscarnetmentioning

confidence: 99%

Drug-induced impairment of renal function

Pazhayattil¹,

Shirali²

2014

IJNRD

116

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Pharmaceutical agents provide diagnostic and therapeutic utility that are central to patient care. However, all agents also carry adverse drug effect profiles. While most of these are clinically insignificant, some drugs may cause unacceptable toxicity that impacts negatively on patient morbidity and mortality. Recognizing adverse effects is important for administering appropriate drug doses, instituting preventive strategies, and withdrawing the offending agent due to toxicity. In the present article, we will review those drugs that are associated with impaired renal function. By focusing on pharmaceutical agents that are currently in clinical practice, we will provide an overview of nephrotoxic drugs that a treating physician is most likely to encounter. In doing so, we will summarize risk factors for nephrotoxicity, describe clinical manifestations, and address preventive and treatment strategies.

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“…Electrolyte abnormalities following fos- carnet infusion include acute ionized hypocalcemia and hypomagnesemia, hypokalemia, and hypo-or hyperphosphatemia. While these changes are often self-limited, serious adverse sequelae can occur, including seizures, arrhythmias, paresthesias, and changes in the sensorium (13,17,18,24,34; Youle et al, Letter). In this study foscarnet-associated symptoms were infrequent, and MgSO 4 appeared to be of no benefit in preventing them.…”

Section: Discussionmentioning

confidence: 99%

“…AIDS, 1993). Clinical symptoms associated with foscarnet-induced ionized hypocalcemia include nausea, headache, paresthesias, seizures, generalized neuromuscular irritability, including tetany, and death (13,17,18,24,34;Youle et al,Letter).…”

mentioning

confidence: 99%

A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection

Huycke¹,

Naguib²,

Stroemmel³

et al. 2000

Antimicrob Agents Chemother

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Foscarnet (trisodium phosphonoformate hexahydrate) is an antiviral agent used to treat cytomegalovirus disease in immunocompromised patients. One common side effect is acute ionized hypocalcemia and hypomagnesemia following intravenous administration. Foscarnet-induced ionized hypomagnesemia might contribute to ionized hypocalcemia by impairing excretion of preformed parathyroid hormone (PTH) or by producing target organ resistance. Prevention of ionized hypomagnesemia following foscarnet administration could blunt the development of ionized hypocalcemia. To determine whether intravenous magnesium ameliorates the decline in ionized calcium and/or magnesium following foscarnet infusions, MgSO 4 at doses of 1, 2, and 3 g was administered in a double-blind, placebo-controlled, randomized, crossover trial to 12 patients with AIDS and cytomegalovirus disease. Overall, increasing doses of MgSO 4 reduced or eliminated foscarnetinduced acute ionized hypomagnesemia. Supplementation, however, had no discernible effect on foscarnetinduced ionized hypocalcemia despite significant increases in serum PTH levels. No dose-related, clinically significant adverse events were found, suggesting that intravenous supplementation with up to 3 g of MgSO 4 was safe in this chronically ill population. Since parenteral MgSO 4 did not alter foscarnet-induced ionized hypocalcemia or symptoms associated with foscarnet, routine intravenous supplementation for patients with normal serum magnesium levels is not recommended during treatment with foscarnet.

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Foscarnet-Induced Severe Hypomagnesemia and other Electrolyte Disorders

Cited by 42 publications

References 9 publications

Magnesium in Man: Implications for Health and Disease

Magnesium in Man: Implications for Health and Disease

Drug-induced impairment of renal function

A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection

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