Cidofovir

Cidofovir is a prescription medication used for the treatment of cytomegalovirus retinitis.

• Cidofovir is available under the following different brand names: Vistide

Adult dosage

Injectable solution

• 75mg/mL

Cytomegalovirus Retinitis

Adult dosage

• Induction treatment: 5 mg/kg Intravenous over 1 hour, once/week for 2 weeks  
• Maintenance treatment: 5 mg/kg Intravenous every 2 weeks
• Serum creatinine (SCr) increase 0.3-0.4 mg/dL above baseline: Reduce to 3 mg/kg Intravenous
• SCr increase above 0.4 mg/dL above baseline: Discontinue therapy

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Cidofovir include:

• nausea,
• vomiting,
• diarrhea,
• weakness,
• headache, and
• hair loss

Serious side effects of Cidofovir include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• swelling,
• rapid weight gain,
• little or no urinating,
• increased thirst,
• loss of appetite,
• constipation,
• pain in the side or lower back,
• fever,
• swollen gums,
• painful mouth sores,
• pain when swallowing,
• skin sores,
• pale skin,
• cold or flu symptoms,
• cough,
• light-headedness,
• shortness of breath,
• severe pain in your upper stomach spreading to the back,
• nausea,
• vomiting,
• fast heart rate,
• vision changes,
• white patches on the eyes,
• cough with yellow or green mucus,
• stabbing chest pain, and
• wheezing

Rare side effects of Cidofovir include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Cidofovir has severe interactions with the following drugs:
  • amikacin
  • amphotericin B deoxycholate
  • contrast media (iodinated)
  • cyclosporine
  • ioversol
  • neomycin PO
  • tacrolimus
  • teicoplanin
  • Cidofovir has serious interactions with the following drugs:
  • acyclovir
  • bacitracin
  • capreomycin
  • carboplatin
  • cephaloridine
  • cisplatin
  • colistin
  • deferiprone
  • gentamicin
  • oxaliplatin
  • pacritinib
  • polymyxin B
  • ropeginterferon alfa 2b
  • streptozocin
  • tobramycin
  • zidovudine
• Cidofovir has moderate interactions with at least 21 other drugs.
• Cidofovir has minor interactions with the following drug:
  • entecavir

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to cidofovir or probenecid
• SCr above1.5 mg/dL, CrCl below 55 mL/min, urine protein above 100 mg/dL (2+ proteinuria)
• Direct intraocular injection
• Concomitant nephrotoxic drugs

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Cidofovir?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Cidofovir?”

Cautions

• Risk of nephrotoxicity (dose-limiting)
• Risk of neutropenia
• Probenecid must be administered w/each dose: 2 g orally 3 hours before cidofovir, 1 g at 2 hours & 8 hours after completion of cidofovir infusion
• 1 L saline Intravenous with each cidofovir infusion; 1 additional liter if the patient can tolerate

Pregnancy & Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • It is not known whether cidofovir is excreted in milk. It should not be administered to nursing mothers. The CDC advises HIV-infected women not to breastfeed to avoid postnatal transmission of HIV.