Search
cidofovir (Vistide)
Tradename: Vistide.
Indications:
- CMV retinitis in AIDS patients
- most common antiviral used for adenovirus infection [4]
Dosage:
1) 5 mg/kg weekly for 2 consecutive weeks, then 5 mg/kg every other week
2) pre hydration: 1 liter of normal saline
3) probenecid: 2 g must be administered orally 3 hours prior to each dose of cidofovir, then 1 g at 2 & at 8 hours after completion of the infusion
Injection: 75 mg/mL, 5 mL.
Dosage adjustment in renal failure:
Creatinine clearance induction maintenance
41-45 mL/min 2.0 mg/kg 2.0 mg/kg
30-40 mL/min 1.5 mg/kg 1.5 mg/kg
20-29 mL/min 1.0 mg/kg 1.0 mg/kg
<19 mL/min 0.5 mg/kg 0.5 mg/kg
Pharmacokinetics:
- does NOT require intracellular phosphorylation for activity
Monitor: serum creatinine, urine protein, WBC with each dose, intraocular pressure, visual acuity, ocular symptoms
Adverse effects:
1) common (>10%)
- dose-dependent nephrotoxicity infection, fever/chills, headache, amnesia, anxiety, confusion, seizures, insomnia, alopecia, rash, acne, skin discoloration, nausea/vomiting, diarrhea, anorexia, abdominal pain, constipation, dyspepsia, gastritis, thrombocytopenia, neutropenia, anemia, weakness, paresthesia, conjunctivitis, ocular hypotony, renal tubular damage, proteinuria, creatinine elevation, asthma, bronchitis, cough, dyspnea, pharyngitis
2) less common (1-10%)
- hypotension, pallor, syncope, tachycardia, dizziness, hallucinations, depression, somnolence, malaise, pruritus, urticaria, hyperglycemia, hyperlipidemia, hypocalcemia, hypokalemia, dehydration, abnormal taste, stomatitis, urinary incontinence, urinary tract infection, skeletal pain, retinal detachment, iritis, uveitis, abnormal vision, hematuria, glycosuria, pneumonia, rhinitis, sinusitis, diaphoresis
Interactions
drug interactions
General
antiviral agent
Properties
MISC-INFO: elimination route KIDNEY
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Deprecated Reference
- Hibbert KA, Shepard JAO, Lane RJ, Azar MM.
Case 1-2018 - A 39-Year-Old Woman with Rapidly Progressive
Respiratory Failure.
N Engl J Med 2018; 378:182-190. January 11, 2018
PMID: 29320657
http://www.nejm.org/doi/full/10.1056/NEJMcpc1712222
- Department of Veterans Affairs, VA National Formulary