Cidofovir: Difference between revisions
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==Background== |
==Background== |
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*Acyclic nucleoside phosphonate that competes with cytosine nucleotides to inhibit viral DNA polymerase |
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*Cytosine nucleotide analogue that inhibits DNA polymerase in [[human herpesviruses]] |
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*Indications: {{#ask: [[Is treated by::cidofovir]] | default=none}} |
*Indications: {{#ask: [[Is treated by::cidofovir]] | default=none}} |
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*Unlike [[ganciclovir]], it does ''not'' need phosphorylation by UL97 |
*Unlike [[ganciclovir]], it does ''not'' need phosphorylation by UL97 |
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*Does not penetrate CSF |
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==Dosing== |
==Dosing== |
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==Safety== |
==Safety== |
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*Major adverse effect is [[Adverse drug reaction:: |
*Major adverse effect is dose-dependent, irreversible [[Adverse drug reaction::renal tubular necrosis]], which may be prevented by [[probenecid]] |
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**Contraindicated when creatinine >132 μmol/L, CrCl <55 mL/min, or urine protein ≥100 mg/dL (2+ proteinuria) |
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*[[Neutropenia]] |
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*Acute [[iritis]] |
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[[Category: |
[[Category:Acyclic nucleoside phosphonates]] |
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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
