cidofovir (Rx)

Brand and Other Names:Vistide
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 75mg/mL
more...

Cytomegalovirus Retinitis

Induction treatment: 5 mg/kg IV over 1 hour, once/week x2 weeks 

Maintenance treatment: 5 mg/kg IV q2Weeks

Serum creatinine (SCr) increase 0.3-0.4 mg/dL above baseline: Reduce to 3 mg/kg IV

SCr increase >0.4 mg/dL above baseline: Discontinue therapy

Monitor: SCr, urine protein, WBC with differential prior to each dose, IOP, visual acuity

Concomitant Therapy

Must administer probenecid orally with each dose of cidofovir

Probenecid dose: Must administer 2 g of probenecid 3 hours prior to each cidofovir dose and 1 g at 2 hours and again at 8 hours after completion of 1 hour cidofovir infusion (for a total of 4 g); ingestion of food prior to each dose of probenecid may reduce drug-related nausea and vomiting

Hydration: Must receive at least 1 L of 0.9% (normal) saline solution IV prior to each infusion of cidofovir; should administer over 1-2 hours; may administer a second liter over 1-3 hours at start of cidofovir infusion or immediately following infusion if tolerated

<18 years old: Safety & efficacy not established

Next:

Interactions

Interaction Checker

and cidofovir

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Infection

            Chills

            Fever

            Headache

            Amnesia

            Anxiety

            Confusion

            Seizures

            Insomnia

            Weakness

            Paresthesia

            Alopecia

            Rash

            Acne

            Skin discoloration

            Nausea

            Vomiting

            Diarrhea

            Anorexia

            Abdominal pain

            Constipation

            Dyspepsia

            Gastritis

            Thrombocytopenia

            Neutropenia

            Anemia

            Amblyopia

            Conjunctivitis

            Ocular hypotony

            Tubular damage

            Proteinuria

            Elevated creatinine

            1-10%

            Hypotension

            Diaphoresis

            Pallor

            Syncope

            Tachycardia

            Dizziness

            Hallucinations

            Depression

            Somnolence

            Malaise

            Pruritus

            Urticaria

            Hyperglycemia

            Hyperlipidemia

            Hypocalcemia

            Hypokalemia

            Dehydration

            Abnormal taste

            Stomatitis

            Glycosuria

            Hematuria

            Urinary incontinence

            Urinary tract infections

            Skeletal pain

            Retinal detachment

            Iritis

            Uveitis

            Abnormal vision

            Pneumonia

            Rhinitis

            Sinusitis

            Allergic reactions

            Previous
            Next:

            Warnings

            Black Box Warnings

            Renal impairment is the major toxicity, and acute renal failure resulting in dialysis or contributing to death have occurred with as few as 1 or 2 doses

            Reduce nephrotoxicity risk by IV prehydration with normal saline, and administration of probenecid must be used with each infusion

            Renal function (serum creatinine and urine protein) must be monitored within 48 hr prior to each dose, and, if necessary, modify dose in renal function as appropriate

            Contraindicated if taking other nephrotoxic agents

            Neutropenia observed; monitor neutrophil counts

            Indicated only for the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS)

            Animal studies showed cidofovir was carcinogenic, teratogenic, and caused hypospermia

            Contraindications

            Hypersensitivity to cidofovir or probenecid

            SCr >1.5 mg/dL, CrCl <55 mL/min, urine protein >100 mg/dL (2+ proteinuria)

            Direct intraocular injection

            Concomitant nephrotoxic drugs

            Cautions

            Risk of nephrotoxicity (dose-limiting)

            Risk of neutropenia

            Probenecid must be administered w/each dose: 2 g PO 3 hr before cidofovir, 1 g at 2 hr & 8 hr after completion of cidofovir infusion

            1 L saline IV with each cidofovir infusion; 1 add'l liter if pt can tolerate

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy Category: C

            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 breast-feed to avoid postnatal transmission of HIV.

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next:

            Pharmacology

            Distribution: Vd: 0.54 L/kg; does not cross significantly into CSF

            Protein Bound: <6%

            Half-life elimination: 2.6 hr

            Metabolism: minimal; phosphorylation occurs intracellularly

            Excretion: urine

            Mechanism of Action

            Inhibits viral DNA synthesis in CMV

            Previous
            Next:

            Administration

            IV Preparation

            Administer within 24 hr of dilution; refrigerate if not used immediately but still use within 24 hr

            Admixtures should be allowed to equilibrate to room temp prior to use

            IV Administration

            For IV infusion only

            Infuse in 100 mL NS over 1 hr

            Prehydrate with 1 L of NS IV over 1-2 hr prior to cidofovir infusion; a second liter may be administered over a 1-3 hr period immediately following infusion, if tolerated

            Storage

            Store at controlled room temp

            Store admixtures under refrigeration

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous