Drug Index

Cidofovir

Mechanism :

Cidofovir suppresses cytomegalovirus (CMV) replication by selective inhibition of viral DNA synthesis. Biochemical data support selective inhibition of CMV DNA polymerase by cidofovir diphosphate, the active intracellular metabolite of cidofovir.


Indication :

  • CMV retinitis in AIDS
  • Mucocutaneous acyclovir resistant HSV infection

Contraindications :

Contraindicated in patients with a serum creatinine >1.5 mg/dL, a calculated creatinine clearance ≤55 mL/min, or a urine protein ≥100 mg/dL (equivalent to ≥2 + proteinuria), in patients receiving agents with nephrotoxic potential. Such agents must be discontinued at least seven days prior to starting therapy.

Contraindicated in patients with hypersensitivity to cidofovir, in patients with a history of clinically severe hypersensitivity to probenecid or other sulpha-containing medications.


Dosing :

Hydrate and give with probenecid.
Induction:
5 mg/kg IV infusion over 1 hour once weekly for 2 consecutive weeks.
Maintenance:
5 mg/kg IV infusion over 1 hour once every 2 weeks.

Adverse Effect :

Renal toxicity, proteinuria, neutropenia, decreased intraocular pressure, uveitis, metabolic acidosis.


Interaction :

Probenecid: Probenecid is known to interact with the metabolism or renal tubular excretion of many drugs (e.g., acetaminophen, acyclovir, angiotensin-converting enzyme inhibitors, amino salicylic acid, bar.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
>55Dose as in normal renal function
<55Avoid.

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. 0.5 mg/kg/dose
HDDialysed. 0.5 mg/kg/dose
HDF/High fluxDialysed. 0.5 mg/kg/dose
CAV/VVHDUnknown dialysability. 0.5 mg/ kg/dose

Hepatic Dose :

No dosage adjustments are recommended.
07/02/2024 11:29:47 Cidofovir
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