What is Cidofovir?
Cidofovir, an antiviral medication, is used in the treatment of an eye infection known as cytomegalovirus retinitis (CMV) among people with AIDS (acquired immune deficiency syndrome). Cidofovir can only be used to treat CMV in people with AIDS. Cidofovir does not cure CMV, and it may not stop vision changes. Cidofovir can be used in other ways not mentioned in this guide.
Side effects of Cidofovir
If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: difficulty breathing, hives, swelling of the face, lips, or throat.
Cidofovir may cause serious side effects. If you experience:
- White or yellow patches appear on the eyes.
- If you have kidney problems, they may include swelling, rapid weight gain, decreased urination, constipation, and pain in the side or lower back.
- Low blood cell counts can result in fever, chills and fatigue. They may also include mouth sores or skin sores.
- Pancreatitis: severe pain spreading from your upper stomach to your back. Your experience could also include nausea and vomiting.
Side effects of cidofovir include:
- Nausea, vomiting, diarrhoea;
- Pain, weakness;
- Rash;
- Headache
- Hair loss.
You may experience side effects while taking probenecid. These include:
- Nausea, vomiting;
- Skin rash
- Fever, chills,
There may be other side effects. Need medical advice regarding side effects? Make an appointment to see your GP immediately. The FDA can be contacted at 1-800-FDA-1088 to report side effects.
Warnings
Cidofovir may cause kidney damage after just one or two doses. Do not take cidofovir for 7 days if you've taken any of these drugs: some medicines to treat infections, cancer, osteoporosis, or bowel disorders. Organ transplant rejection. High pressure or pain and arthritis (including Advil Motrin and Aleve).
Before you take this drug
If you are allergic or have any of the following:
- Moderate to severe kidney disease
- A history of severe allergies to probenecid or sulfa drugs
Do not use cidofovir after using certain medicines in the last 7 days.
- Blood pressure medicine;
- Cancer medicine
- Injectable drugs to treat osteoporosis, or Paget’s disease;
- Preventing organ rejection with medication
- Medicines for infections
- Medicines to treat a bowel condition;
- Some pain or arthritis medications (including Advil, Motrin, and Aleve)
Inform your physician of any of the following conditions:
- Kidney disease
- Diabetes
- Pancreas problems
Cidofovir may harm an unborn child if either the mother or father uses it.
- Do not take cidofovir while pregnant if you're a woman. Use birth control during treatment and for 1 month following your last dose.
- Use effective birth control if you are male and your partner could become pregnant. Continue to use birth control at least three months after your last dose.
- Do not wait to tell your doctor if you become pregnant while using cidofovir.
Breastfeeding is not recommended for women with HIV/AIDS. Even if the baby was born HIV-free, the virus can be transmitted to the infant through your breast milk.
How to take cidofovir?
Cidofovir can be given by infusion through a vein. This injection will be given by a healthcare provider. Test your kidney function 48 hours prior to each dose of Cidofovir. Be sure to let your doctor know if you are also taking zidovudine for HIV treatment. On the day of your cidofovir injection, you may need to adjust your dose or stop it. Cidofovir can cause kidney damage after just one or two doses. While you receive cidofovir, you will also be given oral probenecid and intravenous fluids (IV). Your entire treatment could take 6 hours. If you have a stomach upset, take probenecid along with food. Continue to take probenecid as prescribed. You may be at greater risk for complications from cidofovir if you skip doses. Your next cidofovir injection may be delayed due to the results of your medical tests.
Details on dosage
Adult dose for CMV retinitis:
The dose, frequency, and infusion rate must not be exceeded; probenecid and IV saline prehydration must be administered with each dose.
Induction dose: 5 mg/kg IV once per week for two consecutive weeks
Maintenance Dosage: 5 mg/kg IV infusion every two weeks following induction dose.Comments:
dose of probenecid: 2g orally, 3 hours before infusion. Then 1g orally 2 hours after the infusion.
Consult the section on preparation and administration for instructions regarding how to prepare and administer an infusion.
The serum creatinine level and the urine protein levels must be measured within 48 hours after each dose. Because serum creatinine does not always provide a clear picture of renal function in patients with advanced AIDS or CMV retinitis, it is necessary to use the Cockcroft-Gault formula to estimate crcl more accurately.
The safety and efficacy have not been proven for other CMV infections, such as gastroenteritis or congenital CMV diseases.
Adult dose for the smallpox vaccine:
Not approved by the FDA
5 mg/kg IV once
If clinically indicated, a second dose can be given one week after the first.
Cidofovir, available through an IND protocol at the CDC, is used as a second-line treatment for smallpox vaccination complications that have not responded well to vaccinia immunoglobulin treatment.
What happens if I miss the dose?
If you are unable to attend your appointment for a cidofovir shot or have missed a dose of probenecid, call your doctor.
What happens if I overdose?
You will be closely monitored to ensure that you don't receive too much cidofovir. If you show overdose symptoms, your carers will treat you immediately.
What should be avoided?
If your doctor prescribes any restrictions regarding food, beverage, or activity, follow their instructions.
Interaction with other drug
Several drugs can interact with cidofovir. Some drugs should be avoided for 7 days prior to receiving cidofovir. Inform your doctor of all the medicines you are taking and those that you have started or stopped using. Included below are prescription and nonprescription medicines, vitamins, and herbal products; this list does not reflect all possible interactions.
