VOCARVI 24 MG — DIN 02505924

What is VOCARVI?

VOCARVI 24 MG contains FOSCARNET SODIUM : 24 MG. It is listed in the Health Canada Drug Product Database under DIN 02505924, held by STERIMAX INC, supplied as SOLUTION for INTRAVENOUS administration. Health Canada currently lists it as marketed, status dated 30-Mar-2021. Nexara Health is a licensed Canadian wholesale distributor (DEL 3-002896-A) and can source this product for hospitals, pharmacies and clinics. Availability and lead time are confirmed per order.

What is VOCARVI used for?

Vocarvit™ is indicated for: Cytomegalovirus Retinitis • the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS); • combination therapy with Vocarvi™ and ganciclovir for the treatment of CMV retinitis in patients with AIDS who have relapsed after monotherapy with either drug; and Mucocutaneous Acyclovir Resistant Herpes Simplex Virus Infections • the treatment of acyclovir-resistant mucocutaneous herpes simplex virus (HSV) infections in immunocompromised patients.

Authorized indication as written in the Health Canada product monograph. For healthcare professionals and licensed purchasers; this is not medical advice.

How is it administered?

Vocarvi™ is administered by controlled intravenous infusion, either by using a central venous line or by using a peripheral vein. The rate of infusion must be no more than 1 mg/kg/minute. An individualized dose of Vocarvi™ should be calculated on the basis of body weight (mg/kg), renal function, indication of use and dosing frequency. To reduce the risk of nephrotoxicity, creatinine clearance (mL/min/kg) should be calculated even if serum creatinine is within the normal range, and doses should be adjusted accordingly. CMV retinitis: Induction Treatment: The recommended initial dose of Vocarvi™ is 90 mg/kg (1-1/2 to 2-hour infusion) every twelve hours or 60 mg/kg (minimum one hour infusion) every eight hours over 2 to 3 weeks depending on clinical response. Maintenance Treatment: The recommended maintenance dose of Vocarvi™ is 90 mg/kg/day to 120 mg/kg/day given as an intravenous infusion over 2 hours. Most patients are started on maintenance treatment with a dose of 90 mg/kg/day with escalation to 120 mg/kg/day if early reinduction is required because of retinitis progression. Mucocutaneous acyclovir-resistant HSV infections: Induction treatment: Vocarvi™ is administered for 2–3 weeks or until healing of lesions, as intermittent infusions at a dose of 40 mg/kg over one hour every 8 hours in patients with normal renal function. The infusion time should not be shorter than 1 hour. Use in Patients with Abnormal Renal Function: Vocarvi™ should be used with caution in patients with abnormal renal function. Renal function must be monitored carefully at baseline and during induction and maintenance therapy with appropriate dose adjustments. Vocarvi™ is not recommended in patients undergoing hemodialysis because dosage guidelines have not been established. Hydration: It is recommended that 750–1000 mL of normal saline or 5% dextrose solution should be given prior to the first infusion of Vocarvi™ to establish diuresis. With subsequent infusions, 750 to 1000 mL of hydration fluid should be given with 90 to 120 mg/kg of Vocarvi™, and 500 mL with 40 to 60 mg/kg of Vocarvi™. After the first dose, the hydration fluid should be administered concurrently with each infusion of Vocarvi™.

Included because it drives pack selection and wastage. Consult the monograph.

Contraindications

Vocarvi™ is contraindicated in patients who are hypersensitive to this drug or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.

Warnings and precautions

Renal toxicity: Vocarvi™ should be used with caution in patients with reduced renal function. Serum creatinine should be monitored and appropriate dose adjustments should be performed according to renal function. Adequate hydration should be maintained in all patients. QT prolongation: Vocarvi™ has been associated with cases of prolongation of QT interval, including cases of Torsades de Pointes during post-marketing. Patients with known existing prolongation of cardiac conduction intervals, particularly QTc, patients with significant electrolyte disturbances (hypokalemia, hypomagnesaemia), bradycardia, as well as patients with underlying cardiac diseases such as congestive heart failure or who are taking medications known to prolong the QT interval should be carefully monitored due to increased risk of ventricular arrhythmia. Electrolyte disturbances: Vocarvi™ has a propensity to chelate bivalent metal ions, such as calcium and magnesium, and therefore, administration may be associated with an acute decrease of ionized serum calcium proportional to the rate of Vocarvi™ infusion. Electrolyte levels, especially calcium and magnesium, should be assessed prior to and during Vocarvi™ therapy and deficiencies corrected. Seizures: Seizures have been associated with Vocarvi™. Cases of status epilepticus have been reported. Patients should be carefully monitored for such changes and their potential sequelae. As seizures may be related to electrolyte disturbances, mineral and electrolyte supplementation may be required.