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Vistide (cidofovir) Disease Interactions

There are 3 disease interactions with Vistide (cidofovir):

Major

Cidofovir (Includes Vistide) ↔ Dehydration

Severe Potential Hazard, High plausibility

Applies to: Dehydration

Cidofovir is associated with dose-dependent nephrotoxicity, which is minimized by adequate hydration. One liter of normal saline should be infused over 1 to 2 hours prior to each dose of cidofovir in normal adults. Therapy with cidofovir should be administered cautiously in patients who are dehydrated. These patients may be candidates for an additional liter, given over 1 to 3 hours upon the initiation or completion of cidofovir infusion.

References

  1. "Product Information. Vistide (cidofovir)." Gilead Sciences, Foster City, CA.
Major

Cidofovir (Includes Vistide) ↔ Neutropenia

Severe Potential Hazard, High plausibility

Applies to: Neutropenia

Cidofovir may cause neutropenia (20% in clinical trials). Therapy with cidofovir should be administered cautiously in patients with preexisting neutropenia or those receiving concomitant drugs with myelosuppressive effects. With some drugs (e.g., zidovudine or AZT), a temporary interruption of therapy or a reduction in dosage may be necessary on days of cidofovir administration. Close monitoring of neutrophil count is recommended during therapy with cidofovir. Some patients may be candidates for granulocyte colony stimulating factor.

References

  1. Lalezari JP, Drew WL, Glutzer E, James C, Miner D, Flaherty J, Fisher PE, Cundy K, Hannigan J, Martin JC, et al "(S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine (cidofovir): results of a phase I/II study of a novel antiviral nucleotide analogue." J Infect Dis 171 (1995): 788-96
  2. "Product Information. Vistide (cidofovir)." Gilead Sciences, Foster City, CA.
Major

Cidofovir (Includes Vistide) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The initiation of cidofovir therapy is contraindicated in patients with renal impairment defined by a serum creatinine > 1.5 mg/dL, a calculated creatinine clearance <= 55 mL/min, or a urine protein >= 100 mg/dL (i.e., 2+ proteinuria). Cidofovir is associated with dose-dependent nephrotoxicity, which may result in acute renal failure and the need for dialysis in some cases, as well as Fanconi's syndrome. Patients with normal renal function or mild dysfunction should be monitored closely for declining renal function during cidofovir therapy, and the dosing adjusted or discontinued accordingly. Renal function should be assessed within 48 hours preceding each dose.

References

  1. Lalezari JP, Drew WL, Glutzer E, James C, Miner D, Flaherty J, Fisher PE, Cundy K, Hannigan J, Martin JC, et al "(S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine (cidofovir): results of a phase I/II study of a novel antiviral nucleotide analogue." J Infect Dis 171 (1995): 788-96
  2. "Product Information. Vistide (cidofovir)." Gilead Sciences, Foster City, CA.
  3. Polis MA, Spooner KM, Baird BF, Manischewitz JF, Jaffe HS, Fisher PE, Falloon J, Davey RT Jr, Kovacs JA, Walker RE, et al "Anticytomegaloviral activity and safety of cidofovir in patients with human immunodeficiency virus infection and cytomegalovirus viruria." Antimicrob Agents Chemother 39 (1995): 882-6

Vistide (cidofovir) drug Interactions

There are 162 drug interactions with Vistide (cidofovir)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. 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.

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