Adverse Reaction:
Adverse reactions-
Nephrotoxicity - renal impairment is a major toxicity of cidofovir
Cidofovir is contraindicated in patients who are receiving other nephrotoxic agents.
Decreased IOP /Ocular hypotony- risk of ocular hypotony may be increased in patients with
pre-existing diabetes melitus.
Cardiovascular- cardiopathy, cardiovascular disorder, congestive heart failure,
hypertension, hypotension, migraine, pallor, peripheral vascular
disorder ,phlebitis, postural hypotension, shock,
CNS- Abnormal dreams, abnormal gait, acute brain syndrome, agitation, amnesia,
anxiety, ataxia, cerbrovascular disorder, confusion, convulsion, delirium
Dermatologic- acne, alopecia, angioedema, dry skin, eczema, exfoliative dermatitis,
herpes simplex, nil disoder, skin discoloration, skin hypertrophy, urticaria
Endocrine- adrenal cotex insufficiency
GI - anorexia, abdominal pain, cholangitis, colitis, cponstipaion, diarrhea, dry mouth,
dyspepsia, gastritis, GI haemorhage, gingivitis, hepatitis
GU- decreased creatinin clearance, dysuria, glysuria, hematuria, kidney stone, mastitis,
metrorrhagia, noctiria, polyuria, uretthritis, urinary casts, urinary incontinuance,
urinary tract infection
Hematologic/lymphatic- hypochromic anmia, leukocytosis, lymphasdenopathy,
thrombocytopenia, splenomegaly
Metabolic/nutrional - cachexia, dehydration, edema, hyperglycemia, hyperkalemia,
hypocalcalcemia, hypoglycemic reactions, increased BUN
Musculoskeletal - arthalgia, bone necrosis, bone pain, joint disorder. leg cramps,
myalgia, myasthenia gravis and pathological fractures,
Respiratory - asthma, bronchitis, coughing, hyperventilation,increased sputum,
larynx edema, pharyngitis, rhinitis, and sinusitis
Special senses- abnormal vision,blindness, cataract, conjuntivitis, corneal lesion,
corneal opacity, diplopia, dry eyes, ear disorder, ear pain, eye pain,
Miscellaneous- abdominal pain, accidental injury, allergic reactions, back pain, chest pain
face edema, neck pain
Contra-Indications:
History of clinically severe hypersensitivity to probenecid
Special precautions-
Hematological toxcity - neutropenia may occur during cidofovir therapy. Neutrophil count
should be monitored while receiving cidofovir therapy
Decreased IOP - decreased intraocular pressure IOP may occur during cidofovir therapy
and in some cases associated with decreased visual acuity.
Metabolic acidosis- metabolic acidosis in association with liver dysfunction and pancreatitis
resulting in death has been reported in patients with cidofovir
Nephrotoxicity - dose dependent nephrotoxicity is themajor limiting toxicity related to
cidofovir administration
Renal function impairment -renal impairment is a major toxicity of cidofovir
Pregnancy- cidofovir should be used during pregnancy only if the potential benefit justifies
the potential risk to the fetus.
Lactation- cidofovir should not be administred to nursing mothers.
Children - safety and efficacy in children have not been established
Elderly- particular attention to be paid to assessment of renal function before and during
cidofovir administration
Monitoring- serum creatinine and urine protein must be monitored withi 48 hours prior to
each dose. White cells counts with differential should be monitoredprior to each dose