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 :
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)
>55 | Dose as in normal renal function |
<55 | Avoid. |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Not dialysed. 0.5 mg/kg/dose |
HD | Dialysed. 0.5 mg/kg/dose |
HDF/High flux | Dialysed. 0.5 mg/kg/dose |
CAV/VVHD | Unknown dialysability. 0.5 mg/ kg/dose |
Hepatic Dose :
No dosage adjustments are recommended.