Thursday, October 6, 2016

cidofovir


Generic Name: cidofovir (si DOF o veer)

Brand Names: Vistide


What is cidofovir?

Cidofovir is an antiviral medication that works by preventing certain viral cells from multiplying in your body.


Cidofovir is used to treat an eye infection called cytomegalovirus retinitis (CMV) in people who are infected with HIV (human immunodeficiency virus).


Cidofovir may also be used for purposes other than those listed in this medication guide.


What is the most important information I should know about cidofovir?


Do not receive this medication if you are allergic to cidofovir, probenecid (Benemid), or sulfa drugs, or if you have severe kidney disease. Cidofovir may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Use an effective form of birth control while you are using cidofovir and for at least 1 month after your treatment ends.

Cidofovir can affect fertility (ability to have children) in men. If a man fathers a child while using this medication, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment. Continue using condoms for at least 3 months after you stop using cidofovir.


Cidofovir must be used together with an oral (taken by mouth) medicine called probenecid (Benemid). Be sure to read the medication guide or patient instructions provided with each of your medications.


There are many other medicines that can interact with cidofovir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Cidofovir has caused certain types of tumors in animals. It is not known if humans would also have an increased risk of tumors. Talk with your doctor about your specific risk.


What should I discuss with my health care provider before receiving cidofovir?


Do not receive this medication if you are allergic to cidofovir, probenecid (Benemid), or sulfa drugs, or if you have severe kidney disease.

Do not receive cidofovir if you have used any of the following medications within the past 7 days:



  • pentamidine (Nebupent, Pentam);




  • tacrolimus (Prograf);




  • amphotericin B (Fungizone, AmBisome, Amphotec, Abelcet);




  • antibiotics such as capreomycin (Capastat), rifampin (Rifadin, Rimactane, Rifater), vancomycin (Vancocin, Vancoled);




  • antiviral medicines such as acyclovir (Zovirax), adefovir (Hepsera), or foscarnet (Foscavir); or




  • cancer medicine such as aldesleukin (Proleukin), carmustine (BiCNU, Gliadel), cisplatin (Platinol), ifosfamide (Ifex), oxaliplatin (Eloxatin), plicamycin (Mithracin), streptozocin (Zanosar), or tretinoin (Vesanoid).



Before using cidofovir, tell your doctor if you are allergic to any drugs, or if you have kidney disease. You may not be able to receive cidofovir, or you may need dosage adjustments or special tests during treatment.


FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Use an effective form of birth control while you are using cidofovir and for at least 1 month after your treatment ends.

This medication can affect fertility (ability to have children) in men. If a man fathers a child while using this medication, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment. Continue using condoms for at least 3 months after you stop using cidofovir.


It is not known whether cidofovir passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

Cidofovir has caused certain types of tumors in animals. It is not known if humans would also have an increased risk of tumors. Talk with your doctor about your specific risk.


How is cidofovir used?


Cidofovir is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. The medicine must be given slowly through an IV infusion. You may also be given an IV saline solution for 1 to 3 hours before and after you receive your cidofovir injection. This IV treatment can take up to 6 hours to complete.


To keep you from getting dehydrated, you may also be given an IV saline solution for 1 to 3 hours before and after you receive your cidofovir injection. Your IV treatment can take up to 6 hours to complete.


Cidofovir must be used together with an oral (taken by mouth) medicine called probenecid (Benemid). Be sure to read the medication guide or patient instructions provided with each of your medications.


Cidofovir and probenecid are usually given once a week for 2 weeks, and then once every 2 weeks. It is important to receive this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated.


To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled visits to your doctor.


What happens if I miss a dose?


Call your doctor if you miss an appointment to receive your cidofovir injection.


What happens if I overdose?


Seek emergency medical attention if you think you have received too much of this medicine.

Symptoms of a cidofovir overdose are not known.


What should I avoid while receiving cidofovir?


There are no restrictions on food, beverages, or activity while using cidofovir unless your doctor has told you otherwise.


Cidofovir side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • urinating less than usual or not at all;




  • fever, chills, body aches, flu symptoms;




  • any change in your vision; or




  • increased thirst and urination, loss of appetite, weakness, constipation.



Less serious side effects are more likely to occur, such as:



  • nausea, vomiting, diarrhea, loss of appetite;




  • white patches or sores inside your mouth or on your lips;




  • headache;




  • mild skin rash;




  • hair loss; or




  • cough.



Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.


Cidofovir Dosing Information


Usual Adult Dose for CMV Retinitis:

Induction dose: 5 mg/kg via IV infusion once a week for 2 consecutive weeks
Maintenance dose: Following induction dose, 5 mg/kg via IV infusion once every 2 weeks

Probenecid 2 g orally must be given 3 hours prior to the cidofovir infusion. Probenecid 1 g orally must be given at 2 and 8 hours following completion of the cidofovir infusion (for a total probenecid dose of 4 g).

Usual Adult Dose for Smallpox Vaccine Reaction:

(Not approved by FDA)

5 mg/kg via IV infusion once

A second dose 1 week later may be considered if clinically indicated.

Cidofovir is available under an IND protocol from the CDC as a second-line treatment of severe smallpox vaccine complications that have not responded to vaccinia immune globulin (VIG) treatment.


What other drugs will affect cidofovir?


Before using cidofovir, tell your doctor if you are using any of the following drugs:



  • acetaminophen (Tylenol);




  • acyclovir (Zovirax);




  • zidovudine (Retrovir, AZT);




  • bumetanide (Bumex);




  • clofibrate (Atromid);




  • famotidine (Pepcid);




  • furosemide (Lasix);




  • methotrexate (Rheumatrex, Trexall);




  • theophylline (Elixophyllin, Respbid, Theobid, Theo-Dur, and others);




  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others;




  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);




  • a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or




  • diazepam (Valium) or similar medicines such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), estazolam (ProSom), flurazepam (Dalmane), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others.



If you are using any of these drugs, you may not be able to receive cidofovir, or you may need dosage adjustments or special tests during treatment.


There may be other drugs not listed that can affect cidofovir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



More cidofovir resources


  • Cidofovir Side Effects (in more detail)
  • Cidofovir Dosage
  • Cidofovir Use in Pregnancy & Breastfeeding
  • Cidofovir Drug Interactions
  • Cidofovir Support Group
  • 0 Reviews for Cidofovir - Add your own review/rating


  • cidofovir Intravenous Advanced Consumer (Micromedex) - Includes Dosage Information

  • Cidofovir Professional Patient Advice (Wolters Kluwer)

  • Cidofovir Monograph (AHFS DI)

  • Cidofovir MedFacts Consumer Leaflet (Wolters Kluwer)

  • Vistide Prescribing Information (FDA)



Compare cidofovir with other medications


  • CMV Retinitis
  • Smallpox Vaccine Reaction


Where can I get more information?


  • Your pharmacist has information about cidofovir written for health professionals that you may read.

See also: cidofovir side effects (in more detail)


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