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Cidofovir Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 17, 2023.

Applies to cidofovir: intravenous solution.

Important warnings This medicine can cause some serious health issues

Intravenous route (solution)

Acute renal failure resulting in dialysis or contributing to death has been reported.

Use intravenous prehydration with normal saline and administration of probenecid with each cidofovir infusion to reduce nephrotoxicity.

Monitor renal function within 48 hours prior to each dose and adjust dose as appropriate.

Cidofovir is contraindicated in patients who are receiving other nephrotoxic agents.

Neutropenia has been observed; monitor neutrophil counts during therapy.

Cidofovir was carcinogenic, teratogenic, and caused hypospermia in animal studies.

Serious side effects of cidofovir

Along with its needed effects, cidofovir may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Medicines like cidofovir can sometimes cause serious side effects such as blood problems and kidney problems; these are described below. Cidofovir has also been found to cause cancer in animals, and there is a chance it could cause cancer in humans as well. Discuss these possible side effects with your doctor.

Check with your doctor immediately if any of the following side effects occur while taking cidofovir:

More common

  • fever, chills, or sore throat
  • decreased urination
  • increased thirst and urination

Check with your doctor as soon as possible if any of the following side effects occur while taking cidofovir:

Rare

  • decreased vision or any change in vision

Other side effects of cidofovir

Some side effects of cidofovir may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • diarrhea
  • headache
  • loss of appetite
  • nausea
  • vomiting

Less common

  • generalized weakness
  • loss of strength

For healthcare professionals

Applies to cidofovir: intravenous solution.

General

The most commonly reported adverse events include proteinuria, increased serum creatinine, neutropenia, decreased serum bicarbonate, decreased intraocular pressure, fever, and infection.[Ref]

Renal

Nephrotoxicity may be irreversible. Renal impairment, including cases of acute renal failure resulting in dialysis and/or contributing to death, has occurred with as few as one or two doses of the drug. Proteinuria (greater than 2+), reduced creatinine clearance (less than or equal to 55 mL/min), and/or elevations of serum creatinine concentration (greater than 0.4 mg/dL) occurred in about 59% of patients receiving a maintenance dose of 5 mg/kg every other week. Toxic nephropathy has also been reported.[Ref]

Ocular

The risk of ocular hypotony may be increased in patients with diabetes mellitus.

Uveitis or iritis was reported in 15 (11%) of 135 patients who were administered the 5 mg/kg maintenance dose. Patients should be monitored for signs and symptoms of these complications and if they develop, treatment with topical corticosteroids with or without topical cycloplegic agents may be useful.[Ref]

Metabolic

Genitourinary

Hematologic

Hypersensitivity

Gastrointestinal

Administration of probenecid after a meal and/or therapy with antiemetics may alleviate the nausea and vomiting associated with probenecid.[Ref]

Cardiovascular

Dermatologic

Local

Endocrine

Hepatic

Musculoskeletal

Nervous system

Respiratory

Other

Immunologic

Psychiatric

References

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3. Plosker GL, Noble S (1999) "Cidofovir - A review of its use in cytomegalovirus retinitis in patients with AIDS." Drugs, 58, p. 325-45

4. Segarra-Newnham M, Vodolo KM (2001) "Use of cidofovir in progressive multifocal leukoencephalopathy." Ann Pharmacother, 35, p. 741-4

5. Polis MA, Spooner KM, Baird BF, Manischewitz JF, Jaffe HS, Fisher PE, Falloon J, Davey RT Jr, Kovacs JA, Walker RE, et al. (1995) "Anticytomegaloviral activity and safety of cidofovir in patients with human immunodeficiency virus infection and cytomegalovirus viruria." Antimicrob Agents Chemother, 39, p. 882-6

6. Wald A (1999) "New therapies and prevention strategies for genital herpes." Clin Infect Dis, 28, s4-13

7. Jabs DA (2001) "The ganciclovir implant plus oral ganciclovir versus parenteral cidofovir for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome: The ganciclovir cidofovir cytomegalovirus retinitis trial." Am J Ophthalmol, 131, p. 457-67

8. Szczech LA (2001) "Hypertension and medication-related renal dysfunction in the HIV-infected patient." Semin Nephrol, 21, p. 386-93

9. Perazella MA (2003) "Drug-induced renal failure: update on new medications and unique mechanisms of nephrotoxicity." Am J Med Sci, 325, p. 349-62

10. Izzedine H, Launay-Vacher V, Deray G (2005) "Renal tubular transporters and antiviral drugs: an update." AIDS, 19, p. 455-62

11. Izzedine H, Launay-Vacher V, Deray G (2005) "Antiviral drug-induced nephrotoxicity." Am J Kidney Dis, 45, p. 804-17

12. Shehab N, Sweet BV, Hogikyan ND (2005) "Cidofovir for the treatment of recurrent respiratory papillomatosis: a review of the literature." Pharmacotherapy, 25, p. 977-89

13. Roling J, Schmid H, Fischereder M, Draenert R, Goebel FD (2006) "HIV-Associated Renal Diseases and Highly Active Antiretroviral Therapy-Induced Nephropathy." Clin Infect Dis, 42, p. 1488-95

14. Yusuf U, Hale GA, Carr J, et al. (2006) "Cidofovir for the Treatment of Adenoviral Infection in Pediatric Hematopoietic Stem Cell Transplant Patients." Transplantation, 81, p. 1398-1404

15. Torgovnick J, Sethi N, Karter D, Arsura E (2006) "Remission of AIDS-associated progressive multifocal leukoencephalopathy with combined cidofovir and radiotherapy: a case report." AIDS, 20, p. 1569-1570

16. Lopez V, Sola E, Gutierrez C, et al. (2006) "Anterior Uveitis Associated With Treatment With Intravenous Cidofovir in Kidney Transplant Patients With BK Virus Nephropathy." Transplant Proc, 38, p. 2412-2413

17. Kazory A, Singapuri S, Wadhwa A, Ejaz AA (2007) "Simultaneous development of Fanconi syndrome and acute renal failure associated with cidofovir." J Antimicrob Chemother, 60, p. 193-4

18. Friedberg DN (1997) "Hypotony and visual loss with intravenous cidofovir treatment of cytomegalovirus retinitis." Arch Ophthalmol, 115, p. 801-2

19. Akler ME, Johnson DW, Burman WJ, Johnson SC (1998) "Anterior uveitis and hypotony after intravenous cidofovir for the treatment of cytomegalovirus retinitis." Ophthalmology, 105, p. 651-7

20. Neau D, RenaudRougier MB, Viallard JF, Dutronc H, Cazorla C, Ragnaud JM, Dupon M, Lacut JY (1999) "Intravenous cidofovir-induced iritis." Clin Infect Dis, 28, p. 156-7

21. Tseng AL, Mortimer CB, Salit IE (1999) "Iritis associated with intravenous cidofovir." Ann Pharmacother, 33, p. 167-71

22. Chakrabarti S, Collingham KE, Osman H, Fegan CD, Milligan DW (2001) "Cidofovir as primary pre-emptive therapy for post-transplant cytomegalovirus infections." Bone Marrow Transplant, 28, p. 879-81

23. Cabello V, Margarit N, Diaz Pedrero M, Bernal G, Pereira P, Gentil MA (2008) "Treatment of BK Virus-Associated Nephropathy With Cidofovir in Renal Transplantation." Transplant Proc, 40, p. 2930-2

24. Kay TD, Hogan PG, McLeod S, Johnson DW (2000) "Severe irreversible proximal renal tubular acidosis and azotaemia secondary to cidofovir." Nephron, 86, p. 348-9

Frequently asked questions

Further information

Cidofovir side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.