Cidofovir (Introvenous)

Cidofovir is an injectable antiviral medicine intended for lowering the effects of CMV retinitis for people diagnosed with AIDS.

Overview:

Cidofovir, which goes by the trade name Vistide, is predominantly used to treat eye infections. More specifically, this prescription-only drug is intended for the cytomegalovirus in patients who have been diagnosed with AIDS.

Patients who receive treatment with Cidofovir should not expect a cure for cytomegalovirus. The medicine merely treats the symptoms of the virus and helps to eliminate the discomfort associated with CMV Retinitis, as it's otherwise known.

Cidofovir is classified as an antiviral drug. It is administered intravenously by a qualified medical worker and under the directives of a certified medical practitioner, predominantly in a clinical or hospital setting.

More on Cytomegalovirus Retinitis

CMV Retinitis affects a significant portion of people infected with Acquired Immunodeficiency Virus. Medical statistics reveal that roughly 10-40% of AIDS patients suffer from this condition.

The virus causes the retina of the eyes to become inflamed. If not properly managed, it could lead to blindness. Cidofovir promises to reduce the effects of cytomegalovirus retinitis by inhibiting the natural multiplication process in the human body.

Over the last decade or so, the incidences of cytomegalovirus retinitis in AIDs patients have dropped considerably. However, for patients who may still be afflicted with this condition, Cidofovir is a clear choice to help manage the virus.

Condition(s) Treated:

  • Cytomegalovirus, CMV, CMV Retinitis

Type Of Medicine:

  • Antiviral Medicine, Viral DNA Polymerase Inhibitor

Side Effects:

Cidofovir carries the risk of major to minor side effects, as is the case with most medicines. Below, readers can find commonly studied and rare side effects of the antiviral medicine:

Common Side Effects of Cidofovir

The most commonly noted adverse side effects of Cidofovir include:

  • Symptoms of the Cold or Flu' Such as a sore throat, coughing, and fluctuations in body temperature, for example.
  • Bladder and Kidney Issues ' Some patients report having significant changes in urine volume, including more or less urinary output. When this symptom is reported, another common side effect observed is dehydration or extreme thirst.
  • Appetite Changes ' Some users report a loss of appetite when taking Cidofovir. Moreover, some patients may feel nauseous or even experience frequent bouts of vomiting and/or diarrhea.
  • Headaches ' Migraines or pain in whole or parts of the facial area have been noted in patients using Cidofovir.

Rare Side Effects of Cidofovir

These describe some of the rare side effects of using Cidofovir:

  • Vision Loss: This is a rare and serious side effect of using Cidofovir.
  • Cancer: Though it is unclear if this is a viable side effect in humans, researchers studying animal applications of Cidofovir have concluded that cancer is a feasible side effect in subjects using the drug. The possibility of developing cancer is generally discussed with patients before starting treatment.
  • Lethargy:Extreme weakness or a general feeling of tiredness is a less reported side effect of Cidofovir.

Dosage:

Cidofovir may be used for a viral eye infection, but it is not administered topically. Instead, it is given intravenously.

Patients diagnosed with Acquired Immunodeficiency Syndrome typically exhibit a weakened immune system. As a result, the Cytomegalovirus needs to be treated with a potent IV dose of Cidofovir.

As mentioned earlier, this medicine is administered intravenously into the bloodstream via a slow-drip method.

The dosage amounts vary from one patient to another, and is dependent on:

  • The Duration of the Treatment
  • The Intervals Between the Recommended Doses
  • The Number of Doses Needed Each Day
  • The Patient's Age
  • The Patient's Medical Record
  • The Patient's Body Weight

Average Doses of Cidofovir

Adults:

The initial treatment entails 5mg per kg of body weight | 1 X Weekly | Duration: Two Consecutive Weeks.

Children:

The dose amounts vary and is carefully weighed by the practicing doctor on duty.

Follow Up Treatments

To effectively manage cytomegalovirus, follow up treatments with Cidofovir are required. In adults, medical practitioners generally schedule bi-weekly injections for AIDS patients. The dose amounts are similar to the initial treatment, which is 5mg per body weight for each treatment session.

IV Administration

Cidofovir is administered via an IV solution, which releases this particular medicine into the veins via a slow-drip method. Each treatment session can last for up to six hours. Moreover, post-treatment saline treatments lasting 1-3 hours may also be given to prevent dehydration.

Drugs Prescribed with Cidofovir

For best results, this medicine is most often prescribed simultaneously with Probenecid, which is taken orally. This is done in large part to reduce the risk of renal impairment and nephrotoxicity.

The dose amounts of Probenecid differ based on patient's age, weight, medical history and other key variables.

Cidofovir is supplied in 5ml clear vials containing 375 mg of the solution. To protect workers' health and safety, as well as the patients being treated, IV safety protocols should be adhered to at all times. This means that gloves should be worn to prevent the risk of infectious disease transmissions. After use, used gloves should be disposed of in a biohazard waste container. The same rule of thumb applies to used needles.

Interactions:

Using Cidofovir with other medicines could potentially cause adverse side effects to occur, some more serious than others. Medical practitioners often rely on the findings of past medical research in order to determine the safety of groups of medicines used in conjunction with each other.

Most medical practitioners, for example, rely on a prescriber's reference guide to double-check this information. In the case of Cidofovir, past research has provided a definitive answer to medications that are not recommended for concomitant use with Cidofovir. Some of these drugs include but aren't limited to:

  • Abelcet
  • Ambisome
  • Amikacin
  • Amphotec
  • Capastat
  • Dibekacin
  • Foscarnet
  • Framycetin
  • Fungizone
  • Gentamicin
  • Ifex
  • Kanamycin
  • Nebupent
  • Neomycin
  • Netilmicin
  • Oxaliplatin
  • Pentam
  • Pentamidine
  • Platinol
  • Prograf
  • Proleukin
  • Rifadin
  • Rifampin
  • Rifater
  • Rimactane
  • Streptomycin
  • Tacrolimus
  • Tobramycin
  • Vancocin
  • Vancomycin
  • Zovirax

In the event that Cidofovir is required along with one or more of the above-listed drugs, medical practitioners may adjust the recommended dose of one or more medicines.

Warnings:

Some of the most common precautions for Cidofovir include:

  • Follow-Ups with an Ophthalmologist Required
  • Vision loss is one of the rare and possible side effects of taking Cidofovir. As a precaution, follow-up visits with an ophthalmologist are scheduled to check for any signs of vision loss. In the event this side effect is detected, treatments may be altered or stopped altogether, per the discretion of the medical team managing the patient's case.
  • Cidofovir Prescriptions for Minors Under 18
    'Cidofovir carries potentially serious adverse effects. When prescribed in children, some of the major risks include the chance of developing cancer and infertility issues.
  • Medical practitioners often discuss these risks with parents or guardians before moving forward with the treatment.
  • Cidofovir Prescriptions for Seniors Over 65
  • At this time, medical research for prescribing Cidofovir in geriatric patients has been limited. As a result, it is unclear if the risks are the same for seniors as is the case for minors.
  • As seniors are more predisposed to other underlying conditions, the medication dose may be adjusted to reduce the risk of any side effects. This is a standard protocol for prescribing any type of medication in seniors.
  •  Cidofovir Prescriptions in Expecting Mothers
  • Cidofovir has proven to be harmful to neonates. Tell your doctor if you are pregnant or plan to be before commencing treatment with this medicine.
  • Cidofovir Prescriptions with Underlying Medical Conditions
  • Taking Cidofovir could cause certain preexisting diseases to become worse. These include:
  •  Renal Impairment:Cidofovir use could exacerbate the symptoms of kidney disease. Use with caution and weigh all options before commencing treatment with Cidofovir.
  • Allergies: Tell your doctor if you have a history of allergies, particularly any hypersensitivities to sulfa as this medicine contains this key ingredient.

Storage:

Sterile and unopened vials of Cidofovir can be safely stored at room temperatures of 20°C to 25°C (68°F to 77°F). Prepared mixtures can be refrigerated for a period of up to 24 hours.

Summary:

Cidofovir is recommended exclusively for patients diagnosed with Acquired Immunodeficiency Syndrome (AIDS) who also have CMV retinitis. It is an injectable antiviral medicine that calms the symptoms of the cytomegalovirus.

Cidofovir is prescribed for both children and adults, although use in minors carries the added risk of developing cancer and infertility issues.

Due to some of the rare and potentially serious side effects of using Cidofovir, patients are generally closely monitored for any new signs of serious complications following use. Moreover, ophthalmologists typically work in conjunction with the primary healthcare provider to watch for signs of vision loss.

Cidofovir is administered intravenously via a slow-drip method, in most cases. Most doses prescribed entail once a week treatment for two consecutive weeks initially. Following this preliminary treatment, a bi-weekly schedule is set in place.

It is important to note that Cidofovir is not a cure for cytomegalovirus, but simply a management treatment. In essence, it inhibits the multiplication of viral cells associated with cytomegalovirus retinitis.