Brands, Medical Use, Clinical Data
Drug Category
- Anti-HIV Agents
- Radiation-Sensitizing Agents
- Antivirals
- Antineoplastic Agents
Dosage Forms
Brands / Synonyms
CDV; Cidofovir Anhydrous; HPMPC; Vistide; Vistide
Indications
For the treatment of CMV retinitis in patients with acquired immunodeficiency syndrome (AIDS)
Pharmacology
Cidofovir is a new anti-viral drug. It is classified as a nucleotide analogue and is active against herpes cytomegalovirus (CMV) retinitis infection. Most adults are infected with CMV. Cidofovir suppresses cytomegalovirus (CMV) replication by selective inhibition of viral DNA synthesis. Biochemical data support selective inhibition of CMV DNA polymerase by cidofovir diphosphate, the active intracellular metabolite of cidofovir. Cidofovir diphosphate inhibits herpesvirus polymerases at concentrations that are 8- to 600-fold lower than those needed to inhibit human cellular DNA polymerase alpha, beta, and gamma(1,2,3). Incorporation of cidofovir into the growing viral DNA chain results in reductions in the rate of viral DNA synthesis.
Mechanism of Action
Cidofovir acts through the selective inhibition of viral DNA polymerase.
Absorption
100%
Toxicity
Kidney damage, fall in the number of white blood cells, decreased platelets
Biotrnasformation / Drug Metabolism
Not Available
Contraindications
Initiation of therapy with VISTIDE is contraindicated in patients with a serum creatinine > 1.5 mg/dL, a
calculated creatinine clearance ≤ 55 mL/min, or a urine protein ≥ 100 mg/dL (equivalent to ≥ 2 +
proteinuria).
VISTIDE is contraindicated in patients receiving agents with nephrotoxic potential. Such agents must be
discontinued at least seven days prior to starting therapy with VISTIDE.
VISTIDE is contraindicated in patients with hypersensitivity to cidofovir.
VISTIDE is contraindicated in patients with a history of clinically severe hypersensitivity to probenecid or other
sulfa-containing medications.
Direct intraocular injection of VISTIDE is contraindicated; direct injection of cidofovir has been associated with
iritis, ocular hypotony, and permanent impairment of vision.
Drug Interactions
Probenecid : Probenecid is known to interact with the metabolism or renal tubular excretion of
many drugs (e.g., acetaminophen, acyclovir, angiotensin-converting enzyme inhibitors, aminosalicylic acid,
barbiturates, benzodiazepines, bumetanide, clofibrate, methotrexate, famotidine, furosemide, nonsteroidal
anti-inflammatory agents, theophylline, and zidovudine). Concomitant medications should be carefully assessed.
Zidovudine should either be temporarily discontinued or decreased by 50% when coadministered with probenecid on the
day of VISTIDE infusion.
Nephrotoxic agents : Concomitant administration of VISTIDE and agents with nephrotoxic
potential [e.g., intravenous aminoglycosides (e.g., tobramycin, gentamicin, and amikacin), amphotericin B, foscarnet,
intravenous pentamidine, vancomycin, and non-steroidal anti-inflammatory agents] is contraindicated. Such agents must
be discontinued at least seven days prior to starting therapy with VISTIDE.
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