Cidofovir

Cidofovir is a substance from the group of virustatics, a nucleoside analog that is approved for the treatment of CMV retinitis in patients with HIV infection. After phosphorylation to its active diphosphate form, it inhibits the viral DNA polymerase and integrates into the viral DNA chain, thereby blocking DNA synthesis. This mechanism inhibits the replication of DNA viruses such as cytomegalovirus (CMV).

Note: Cidofovir is known for its nephrotoxicity, which requires careful monitoring of renal function and hydration therapy before and after administration.

Initial 5 mg/kg bw i.v. once/week for 2 weeks. Maintenance dose from week 3: 5 mg/kg bw i.v. 1 time/14 days.

Remember! Slow infusion over at least 1 hour. Due to the pronounced nephrotoxicity, administration of probenicid 2 g three hours before and 1 g two and eight hours after cidovofir. Infuse 1 liter of 0.9% NaCl solution immediately before administering cidofovir!

Cidofovir is also available as a topical and well-tolerated gel to be applied twice daily.

With systemic application:

• Neutropenia
• headache
• Nausea, vomiting
• Alopecia, exanthema
• Proteinuria, increase in creatinine
• Asthenia, fever

Caution! Probenicid intolerance

Cidofovir must not be used in patients with known hypersensitivity to the active substance. Cidofovir must not be used in patients who cannot be given probenecid or other sulfonamide-based drugs. Furthermore, cidofovir must not be used in patients with renal insufficiency. The simultaneous administration of cidofovir and other potentially nephrotoxic agents is contraindicated.

Direct intraocular injection of cidofovir is also contraindicated, as this is associated with a significant drop in intraocular pressure and visual impairment.

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