Cidofovir: Difference between revisions

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==Background==
* Cytosine nucleotide analogue that inhibits DNA polymerase in [[human herpesviruses]]
* Unlike [[ganciclovir]], it does ''not'' need phosphorylation by UL97
* Indications: {{#ask: [[Is treated by::cidofovir]] | default=none}}


*Acyclic nucleoside phosphonate that competes with cytosine nucleotides to inhibit viral DNA polymerase
[[Category:Antivirals]]
*Indications: {{#ask: [[Is treated by::cidofovir]] | default=none}}

===Spectrum of Activity===

*Active against essentially all [[:Category:DNA viruses|DNA viruses]], including polyomaviruses ([[BK virus]], [[JC virus]]), [[human papillomavirus]], [[adenovirus]], all of the [[human herpesviruses]], poxviruses (including [[monkeypox virus]] and [[variola virus]])
*Not active against h[[Hepatitis B virus|epatitis B virus]] or [[:Category:RNA viruses|RNA viruses]]

===Pharmacokinetics and Pharmacodynamics===

*Unlike [[ganciclovir]], it does ''not'' need phosphorylation by UL97
*Does not penetrate CSF

==Dosing==

*Should be given with [[probenecid]] 2 g IV prior to each dose

==Safety==

*Major adverse effect is dose-dependent, irreversible [[Adverse drug reaction::renal tubular necrosis]], which may be prevented by [[probenecid]]
**Contraindicated when creatinine >132 μmol/L, CrCl <55 mL/min, or urine protein ≥100 mg/dL (2+ proteinuria)
*[[Neutropenia]]
*Acute [[iritis]]

[[Category:Acyclic nucleoside phosphonates]]

Latest revision as of 23:14, 14 September 2020

Background

Spectrum of Activity

Pharmacokinetics and Pharmacodynamics

  • Unlike ganciclovir, it does not need phosphorylation by UL97
  • Does not penetrate CSF

Dosing

  • Should be given with probenecid 2 g IV prior to each dose

Safety

  • Major adverse effect is dose-dependent, irreversible renal tubular necrosis, which may be prevented by probenecid
    • Contraindicated when creatinine >132 μmol/L, CrCl <55 mL/min, or urine protein ≥100 mg/dL (2+ proteinuria)
  • Neutropenia
  • Acute iritis