Cidofovir
- Atc Codes:J05AB12
- CAS Codes:149394-66-1#113852-37-2
- PHARMGKB ID:149394-66-1#113852-37-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Vistide; Belgium: Vistide; Czech Republic: Vistide; Estonia: Vistide; Finland: Vistide; France: Vistide; Germany: Vistide; Greece: Vistide; Hungary: Vistide; Ireland: Vistide; Italy: Vistide; Latvia: Vistide; Lithuania: Vistide; Luxembourg: Vistide; Malta: Vistide; Netherlands: Vistide; Poland: Vistide; Portugal: Vistide; Romania: Vistide; Slovakia: Vistide; Slovenia: Vistide; Spain: Vistide; Sweden: Vistide; UK: Vistide.
North America
USA: Vistide.
Drug combinations
Chemistry
Cidofovir: C~8~H~14~N~3~O~6~P 2H~2~O. Mw: 315.22. (1) Phosphonic acid, [[2-(4-amino-2-oxo-1(2H)-pyrimidinyl)-1-(hydroxymethyl)ethoxy]methyl]-, dihydrate, (S)-; (2) [[(S)-2-(4-Amino-2-oxo-1(2H)-pyrimidinyl)-1-(hydroxymethyl)ethoxy]methyl]phosphonic acid, dihydrate; (3) 1-[(S)-3-Hydroxy-2-(phosphonomethoxy)propyl]cytosine dihydrate. CAS-149394-66-1; CAS-113852-37-2 (anhydrous)(1994).
Pharmacologic Category
Antivirals; Nucleosides and Nucleotides. (ATC-Code: J05AB12).
Mechanism of action
Cidofovir inhibits viral replication by competitive inhibition of viral DNA polymerase and incorporation and termination of the growing viral DNA chain. Active against various Herpesviridae, including cytomegalovirus, herpes simplex virus types 1 and 2, varicella-zoster virus, and Epstein-Barr virus. Also active in vitro against adenovirus, human papillomavirus, and human polyomavirus. Has in vitro activity against poxviruses, including vaccinia virus (cowpox), monkeypox, and variola virus. May be active against some ganciclovir-resistant cytomegaloviruses and some acyclovir-resistant herpes simplex viruses.
Therapeutic use
Cytomegalovirus retinitis in acquired immunodeficiency syndrome.
Pregnancy and lactiation implications
Teratogenic and embryotoxic in animal studies. Use during pregnancy only if the potential benefit to the mother outweighs the possible risk to the fetus. Use contraindicated during lactation.
Unlabeled use
Infections due to ganciclovir-resistant cytomegalovirus, foscarnet-resistant cytomegalovirus, acyclovir-resistant herpes simplex virus or varicella-zoster virus, and adenovirus. Recurrent respiratory papillomatosis.
Contraindications
Hypersensitivity to cidofovir. History of clinically-severe hypersensitivity to probenecid or other sulfa-containing medications. Serum creatinine >1.5 mg/dL, CrCl <55 mL/minute, or urine protein ≥100 mg/dL. Use with or within 7 days of nephrotoxic agents. Direct intraocular injection of the intravenous preparation.
Warnings and precautions
Possibly carcinogenic and teratogenic, based on animal data. May cause hypospermia. Metabolic acidosis might occur. Dose adjustment or discontinuation if changes in renal function occur during therapy. Neutropenia reported. Cases of ocular hypotony. Indicated only for CMV retinitis treatment in HIV patients.