Meningitis: What It Is and How to Avoid It Watch Video

cidofovir

Generic Name: cidofovir (si DOF o veer)
Brand Name: Vistide

What is cidofovir?

Cidofovir is an antiviral medication that prevents certain viral cells from multiplying in your body.

Cidofovir is used to treat an eye infection called cytomegalovirus retinitis (CMV) in people who have AIDS (acquired immunodeficiency syndrome). Cidofovir is not a cure for CMV or AIDS.

Cidofovir is for treating CMV only in people who have AIDS.

Cidofovir may also be used for purposes not listed in this medication guide.

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

Cidofovir is for treating cytomegalovirus retinitis (CMV) only in people who have AIDS (acquired immunodeficiency syndrome).

You should not receive cidofovir if you have moderate to severe kidney disease, or a history of severe allergic reaction to probenecid (Benemid) or sulfa drugs.

Cidofovir can harm your kidneys. You should not receive cidofovir if you have used any of the following drugs within the past 7 days: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, medicine to prevent organ transplant rejection, injectable medications to treat osteoporosis or Paget's disease, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Slideshow: Worried About Ebola? You’re More Likely to Get These 10 Serious Infections

Cidofovir can harm your kidneys after only one or two doses. You will be given other medications to help keep your kidneys working properly while you are receiving cidofovir.

Your kidney function will be tested before you receive each dose of cidofovir. You may need frequent blood tests to be sure this medication is not causing other harmful effects. Your AIDS treatments may be delayed based on the results of these tests.

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?

You should not receive cidofovir if you are allergic to it, or if you have:

  • moderate to severe kidney disease; or

  • a history of severe allergic reaction to probenecid (Benemid) or sulfa drugs.

Cidofovir can harm your kidneys. This effect is increased when you also use certain other medicines. Your doctor may need to change your treatment plan if you have used any of the following drugs within the past 7 days:

  • medicines to treat a bowel disorder;

  • medication to prevent organ transplant rejection;

  • antiviral medications;

  • injectable medications to treat osteoporosis or Paget's disease of bone;

  • chemotherapy;

  • some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve); or

  • any injected antibiotics.

To make sure cidofovir is safe for you, tell your doctor if you have:

  • mild kidney disease;

  • diabetes; or

  • pancreas or liver problems.

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.

FDA pregnancy category C. It is not known whether cidofovir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. 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. You should not breast-feed while using this medicine. Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How is cidofovir given?

Cidofovir is injected into a vein through an IV. A healthcare provider will give you this injection.

Cidofovir can harm your kidneys after only one or two doses. You will be given intravenous (IV) fluids and oral probenecid while you are receiving cidofovir.

Cidofovir must be given slowly through an IV infusion. Your IV fluids may be given for up to 3 hours before and after you receive your cidofovir injection. This IV treatment can take up to 6 hours to complete.

The oral probenecid may be taken with food if it upsets your stomach.

Cidofovir and probenecid are usually given once a week for 2 weeks, and then once every 2 weeks. Follow your doctor's instructions.

Keep taking the probenecid for the full prescribed length of time. Skipping doses may increase your risk of complications caused by cidofovir.

Your kidney function will be tested before you receive each dose of cidofovir. You may need frequent blood tests and vision exams to be sure this medication is not causing other harmful effects. Your AIDS treatments may be delayed based on the results of these tests.

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 or call the Poison Help line at 1-800-222-1222.

What should I avoid while receiving cidofovir?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Cidofovir side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • symptoms of kidney failure--swelling, rapid weight gain, little or no urinating, increased thirst, loss of appetite, constipation, pain in your side or lower back;

  • symptoms of a blood cell disorder--fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, pale skin, cold or flu symptoms, cough, feeling light-headed or short of breath;

  • signs of pancreas problems--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • vision changes, white patches on your eyes; or

  • cough with yellow or green mucus, stabbing chest pain, wheezing, feeling short of breath.

Common side effects may include:

  • nausea, vomiting, diarrhea;

  • weakness;

  • headache; or

  • hair loss.

Probenecid is given together with cidofovir, and probenecid may cause:

  • nausea, vomiting;

  • skin rash;

  • fever, chills; or

  • headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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?

Some medicines can interact with cidofovir and should not be used at the same time. There are also some medicines that may interact with probenecid or other medications that are commonly given together with cidofovir. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about cidofovir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2013-11-19, 10:07:36 AM.

Hide
(web1)