ADAP drugs: cidofovir

cidofovir (Vistide, HPMPC)

Drug description
Cidofovir is a new treatment for CMV retinitis infection. Most adults are infected with CMV. Like other infections, the virus which causes this condition takes advantage of a weakened immune system. Active CMV infection typically develops only when a person has a deficiency of cytotoxic T cells that recognize and target CMV-infected cells. CMV can infect different parts of the body, and CMV retinitis, a disease caused by this herpesvirus, can cause blindness. Giliad Sciences, which makes cidofovir, has a Support Services Program that can be reached at (800) 445-3235.

Side effects
Cidofovir can be harmful to the kidneys. If someone is taking cidofovir, doctors need to watch for early signs of kidney problems using blood and urine tests. Decreased urination, increased thirst, or light-headedness after standing up can also be early warning signs of kidney problems. If a person already has kidney problems, cidofovir may not be an appropriate treatment for them.
An alert has been issued about cidofovir causing kidney failure. It is very important to follow the medical guidelines for using cidofovir to avoid this potentially fatal side effect. For copies of the alert and guidelines for medical providers call (800) 445-3235.

Dosage
Cidofovir is given by intravenous infusion, directly into a vein in the arm. The infusion is given once a week for the first two weeks - this is called the induction treatment. The infusion is then given once every other week to keep the CMV infection under control. You do not need a catheter installed to take cidofovir. A catheter is a device that's permanently placed in your chest if you need to take an intravenous drug regularly.

How long it may take to work
CMV retinitis usually stabilizes or sometimes improves with treatment in 10-20 days. Long-term maintenance therapy is necessary. Maintenance treatment means you keep taking the drug to control an infection so that you don't become ill. Retinitis will ultimately recur in most people despite maintenance and can be re-treated with higher doses. You must get periodic eye exams. For prevention, the pill form of ganciclovir may be prescribed for people at risk for active disease.

Managing side effects
To try and prevent kidney damage, cidofovir is given with a lot of fluids. Probenecid, a drug that helps protect the kidneys, must also be given with cidofovir. Unfortunately, probenecid contains sulfa, a substance that can cause allergic reactions. Side effects caused by reactions to sulfa-containing drugs can include rash and fever.

This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/ and www.healthanswers.com/Library/library_fset.asp

The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information

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