Cidofovir
CLINICAL USE
Treatment of CMV retinitis in patients with AIDS, if other agents are unsuitableTreatment of BK polyoma virus in transplant patients (unlicensed)
DOSE IN NORMAL RENAL FUNCTION
5 mg/kg weekly for 2 weeks then once every 2 weeks(See further information for BK polyoma virus treatment)
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
>55 Dose as in normal renal function<55 Avoid. See ‘Other Information’
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugsNone known
ADMINISTRATION
Reconstition
–
Route
IV infusion
Rate of Administration
Over 60 minutes
Comments
Dilute in 100 mL sodium chloride 0.9%
OTHER INFORMATION
Always administer with oral probenecid and intravenous sodium chloride 0.9%Administer 2 hours before dialysis session to benefit from peak concentration without having delayed clearance52–75% of dose dialysed out with high- flux haemodialysisInformation for the treatment of BK polyoma virus in transplant patients is from Pittsburgh. Starting dose was 0.25 mg/kg (if GFR<30 mL/min) in 100 mL sodium chloride 0.9% administered over 1 hour, given every 10–14 days. Hydration pre- and post-dose with 1 litre of sodium chloride 0.9% if tolerated. If no change within 10–14 days increase to 0.3–0.5 mg/kg; dose can be increased up to 1 mg/kg depending on response and side effects. Most patients would need a cumulative dose of 1–1.5 mg/kg. Initially use without probenecid. Monitor blood and urine samples for PCR measurement of viral load. The manufacturer advises to avoid in renal failure but theoretical doses, based on a 70 kg person, are suggested in the following paper