Cidofovir

— THERAPEUTIC CATEGORIES —
  • Viral infections

Cidofovir Generic Name & Formulations

General Description

Cidofovir 75mg/mL; for IV infusion after dilution; preservative-free.

Pharmacological Class

Nucleotide analogue.

How Supplied

Contact supplier.

Cidofovir Indications

Indications

Treatment of cytomegalovirus (CMV) retinitis in patients with AIDS.

Cidofovir Dosage and Administration

Adult

Give by IV infusion over 1hr. Pretreat with oral probenecid (2g three hrs before starting cidofovir dose, and 1g two and eight hrs after cidofovir infusion has ended) and IV normal saline hydration (1L immediately before each dose of cidofovir; patients who can tolerate fluid load should receive a 2nd liter either during or after each dose of cidofovir). Induction: 5mg/kg once weekly for 2 consecutive weeks. Maintenance: 5mg/kg once every 2 weeks; reduce to 3mg/kg if serum creatinine increases 0.3–0.4mg/dL above baseline. Discontinue if serum creatinine increases ≥0.5mg/dL above baseline or if ≥3+ proteinuria develops.

Children

Not recommended.

Cidofovir Contraindications

Contraindications

Serum creatinine >1.5mg/dL or CrCl ≤55mL/min, or urine protein ≥100mg/dL. Severe probenecid or sulfa allergy. Within 7 days of discontinuing other nephrotoxic drugs (eg, amphotericin B, aminoglycosides, foscarnet, IV pentamidine, NSAIDs, vancomycin). Not for intraocular injection.

Cidofovir Boxed Warnings

Boxed Warning

Renal impairment. Neutropenia. Carcinogenic, teratogenic and caused hypospermia. Only for the treatment of CMV retinitis in patients with acquired immunodeficiency syndrome.

Cidofovir Warnings/Precautions

Warnings/Precautions

Do not exceed recommended dose, frequency, or rate of administration (increased risk of nephrotoxicity). Women of childbearing potential should use effective contraception during and 1 month after therapy. Men should use barrier contraception during and 3 months after therapy. Monitor serum creatinine, urine protein, WBC with differential before each dose; monitor intraocular pressure, visual acuity, ocular symptoms and for tinnitus. Handle and dispose of properly. Elderly. Pregnancy (Cat.C), nursing mothers: not recommended.

Cidofovir Pharmacokinetics

See Literature

Cidofovir Interactions

Interactions

See Contraindications. Probenecid interferes with the metabolism or renal tubular secretion of many drugs (including zidovudine, adjust dose).

Cidofovir Adverse Reactions

Adverse Reactions

Elevated serum creatinine, proteinuria, neutropenia, ocular hypotony, uveitis, iritis, metabolic acidosis, GI disturbances, fever, asthenia, rash, headache, alopecia, infection, chills, dyspnea; others: see full labeling.

Cidofovir Clinical Trials

See Literature

Cidofovir Note

Notes

Formerly known under the brand name Vistide.

Cidofovir Patient Counseling

See Literature