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Cidofovir Side Effects

Medically reviewed by Last updated on Jul 29, 2023.

Applies to cidofovir: intravenous solution.


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

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

More common


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

Less common

For Healthcare Professionals

Applies to cidofovir: intravenous solution.


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


Very common (10% or more): Proteinuria (up to 88%), elevated creatinine (up to 24%), nephrotoxicity (up to 59%)

Frequency not reported: Increased BUN[Ref]

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]


Very common (10% or more): Anterior uveitis/iritis (11%); decreased intraocular pressure (24%)

Rare (0.01% to 0.1%): Ocular hypotony

Frequency not reported: Abnormal vision, amblyopia, blindness, cataract, conjunctivitis, corneal lesion, corneal opacity, diplopia, dry eyes, eye pain, iritis, keratitis, refraction disorder, retinal detachment, retinal disorder, uveitis, visual field defect, miosis[Ref]

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]


Very common (10% or more): Anorexia (up to 23%), decreased serum bicarbonate (16%)

Common (1% to 10%): Fanconi-like syndrome

Frequency not reported: Weight loss, weight gain, thirst, respiratory alkalosis, hyperkalemia, hypophosphatemia, hypokalemia, hypomagnesemia, hyperglycemia, dehydration, hypocalcemia, cachexia, hypercalcemia, hyperlipidemia, hypoglycemia, hypoglycemic reaction, hyponatremia, hypoproteinemia, metabolic acidosis[Ref]


Frequency not reported: Glycosuria[Ref]


Very common (10% or more): Neutropenia (up to 43%), anemia (up to 24%)

Frequency not reported: Hypochromic anemia, leukocytosis, leukopenia, lymphadenopathy, lymphoma like reaction, pancytopenia, splenic disorder, splenomegaly, thrombocytopenia, thrombocytopenic purpura[Ref]


Frequency not reported: Hypersensitivity, allergic reaction[Ref]


Very common (10% or more): Nausea (up to 69%), diarrhea (up to 26%). oral moniliasis (up to 18%)

Common (1% to 10%): Nausea with vomiting

Frequency not reported: Dyspepsia, constipation, abdominal pain, cholangitis, colitis, esophagitis, dysphagia, fecal incontinence, flatulence, gastritis, gastrointestinal hemorrhage, gingivitis, melena, pancreatitis, proctitis, rectal disorder, stomatitis, aphthous stomatitis, tongue discoloration, mouth ulceration, tooth caries, dry mouth[Ref]

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


Frequency not reported: Cardiomyopathy, cardiovascular disorder, congestive heart failure, hypertension, hypotension, peripheral vascular disorder, phlebitis, postural hypotension, shock, syncope, tachycardia, vascular disorder, edema, chest pain[Ref]


Very common (10% or more): Alopecia (up to 27%), rash (up to 30%)

Frequency not reported: Cellulitis, cyst, face edema, photosensitivity reaction, acne, angioedema, dry skin, eczema, exfoliative dermatitis, furunculosis, herpes, simplex nail disorder, pruritus, rash, seborrhea, skin discoloration, skin disorder, skin hypertrophy, skin ulcer, sweating, urticaria[Ref]


Frequency not reported: Blocked catheter, injection site reaction[Ref]


Frequency not reported: Adrenal cortex insufficiency[Ref]


Frequency not reported: Hepatitis, hepatomegaly, hepatosplenomegaly, jaundice, abnormal liver function, liver damage, liver necrosis, increased transaminases, increased alkaline phosphatase, increased lactic dehydrogenase[Ref]


Frequency not reported: Arthralgia, arthrosis, bone necrosis, bone pain, joint disorder, leg cramps, myalgia, myasthenia, pathological fracture, neck pain[Ref]

Nervous system

Very common (10% or more): Headache (up to 30%)

Frequency not reported: Acute brain syndrome, cerebrovascular disorder, convulsion, delirium, dementia, dizziness, encephalopathy, facial paralysis, hemiplegia, hyperesthesia, hypertonia, hypotony, incoordination, myoclonus, neuropathy, paresthesia, somnolence, tremor, twitching, ataxia, taste perversion, speech disorder, abnormal gait, peripheral neuritis[Ref]


Very common (10% or more): Dyspnea (up to 23%), increased cough (up to 19%)

Frequency not reported: Asthma, bronchitis, epistaxis, hemoptysis, hiccup, hyperventilation, hypoxia, increased sputum, larynx edema, lung disorder, pharyngitis, pneumothorax, rhinitis, sinusitis, hyperventilation[Ref]


Very common (10% or more): Fever (up to 58%), asthenia (up to 43%), chills (up to 22%)

Frequency not reported: Ear disorder, ear pain, hyperacusis, otitis externa, otitis media, tinnitus, hearing loss, vertigo, malaise[Ref]


Very common (10% or more): Infection (up to 28%)

Frequency not reported: Sepsis, flu-like syndrome


Frequency not reported: Abnormal dreams, agitation, amnesia, anxiety, confusion, depression, drug dependence, insomnia, personality disorder

Frequently asked questions


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

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

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

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

18. Friedberg DN. Hypotony and visual loss with intravenous cidofovir treatment of cytomegalovirus retinitis. Arch Ophthalmol. 1997;115:801-2.

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

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

21. Tseng AL, Mortimer CB, Salit IE. Iritis associated with intravenous cidofovir. Ann Pharmacother. 1999;33:167-71.

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

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

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

Further information

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.