Cidofovir: Difference between revisions

Latest revision as of 23:14, 14 September 2020

Background

Acyclic nucleoside phosphonate that competes with cytosine nucleotides to inhibit viral DNA polymerase
Indications: Adenovirus, CMV after solid organ transplantation, Cytomegalovirus, Herpes simplex virus

Spectrum of Activity

Active against essentially all 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 hepatitis B virus or 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 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

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+==Background==
-* Cytosine nucleotide analogue that inhibits DNA polymerase in [[human herpesviruses]]
-* Should be given with [[probenecid]] 2 g IV prior to each dose
-* Unlike [[ganciclovir]], it does ''not'' need phosphorylation by UL97
-* Indications: {{#ask: [[Is treated by::cidofovir]] | default=none}}
-* Major adverse effect is irreversible renal tubular necrosis, which may be prevented by probenecid
+*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]]