Formulary
Cidofovir: Indications, Dosing, Side Effects and Interactions
Cidofovir is a selective inhibitor of human cytomegalovirus (HCMV) DNA polymerase which inhibits viral DNA synthesis and thereby suppresses HCMV replication.
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Cidofovir: Indications, Dosing, Side Effects and Interactions
Cidofovir is a selective inhibitor of human cytomegalovirus (HCMV) DNA polymerase which inhibits viral DNA synthesis and thereby suppresses HCMV replication.
Drug action
Cidofovir is a selective inhibitor of human cytomegalovirus (HCMV) DNA polymerase which inhibits viral DNA synthesis and thereby suppresses HCMV replication.
Indications and dose
**Cytomegalovirus retinitis in patients with AIDS (in combination with probenecid) (specialist use only)**
- **Adult** (By Intravenous Infusion): Initially 5 mg/kg once weekly for 2 weeks, then maintenance 5 mg/kg every 2 weeks, maintenance treatment to be started 2 weeks after completion of induction treatment.
Cautions
Diabetes mellitus (increased risk of ocular hypotony); ensure concomitant use of probenecid and Sodium Chloride 0.9% Cautions, further information Probenecid and Sodium Chloride 0.9% Manufacturer advises oral probenecid and intravenous Sodium Chloride 0.9% must be administered with each cidofovir dose to prevent nephrotoxicity (consult cidofovir product literature for information on probenecid dosing and recommendations on intravenous hydration); see Prescribing and dispensing information for details on obtaining probenecid.
Contraindications
Concomitant administration with potentially nephrotoxic drugs-discontinue potentially nephrotoxic drugs at least 7 days before starting cidofovir; patients unable to receive probenecid
Side effects
Common or very common Alopecia; asthenia; chills; diarrhoea; dyspnoea; eye inflammation; fever; headache; nausea; neutropenia; ocular hypotony; proteinuria; rash; renal failure; vomiting Uncommon Fanconi syndrome acquired Frequency not known Hearing impairment; nephrotoxicity; pancreatitis Side-effects, further information Manufacturer advises intravenous sodium chloride 0.9% prehydration and concomitant oral probenecid for prevention of nephrotoxicity; consider treatment interruption, or discontinuation if changes in renal function occur-consult product literature.
Interactions
**Other interactions (6):**
- Likewise, tafamidis inhibits the uptake transporters OAT1 and OAT3 (organic anion transporters) with IC50=2.9 M and IC50=2.36 M, respectively, and may cause drug-drug interactions at clinically...
- Renally eliminated medicinal products Since tenofovir is primarily eliminated by the kidneys, co-administration of tenofovir disoproxil with medicinal products that reduce renal function or compete...
- Some examples include, but are not limited to, aminoglycosides, amphotericin B, foscarnet, ganciclovir, pentamidine, vancomycin, cidofovir or interleukin-2 (see section 4.4).
- Renally eliminated medicinal products: Since emtricitabine and tenofovir are primarily eliminated by the kidneys, co-administration of Emtricitabine/ Tenofovir disoproxil with medicinal products...
- Products known to have nephrotoxic or neurotoxic effects: aminoglycosides, gyrase inhibitors, vancomycin, sulfamethoxazole + trimethoprim, NSAIDs, ganciclovir, acyclovir, amphotericin B, ibuprofen...
- Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs (see section 4.4).
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid (no information available).
Hepatic impairment
Manufacturer advises caution (no information available).
Renal impairment
Manufacturer advises avoid if creatinine clearance is less than or equal to 55 mL/minute or if proteinuria is greater than or equal to 100 mg/dL. See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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