cidofovir 75 mg/mL intravenous solution

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Medication name

Generic name:
Cidofovir - injection

Pronunciation
(sye-DOH-foh-veer)

Brand name(s)
Vistide

Warning

This medication may cause serious (possibly fatal) kidney problems. To prevent kidney problems, your doctor will usually prescribe another medication (probenecid) and direct you to receive fluids into a vein. Avoid other medications that may also damage your kidneys (see also Drug Interactions section). Tell your doctor right away if you have any signs of kidney problems, such as change in the amount of urine, frothy urine, or bloody/pink urine.

This medication can lower the body's ability to fight an infection. Tell your doctor promptly if you develop any signs of an infection such as sore throat that doesn't go away, fever, or chills.

Lab and/or medical tests (such as kidney function, complete blood counts) should be performed before each dose to check for these side effects. Consult your doctor for more details. Keep all medical and lab appointments.

Cidofovir has caused tumors in lab animals. Although there is no information in humans, cidofovir should be considered cancer-causing (carcinogenic). See also How to Use section.

Uses

This drug is used with probenecid to treat a certain viral eye infection (retinitis due to cytomegalovirus-CMV) in people with AIDS. It lowers your risk of blindness and other vision problems. Cidofovir belongs to a class of drugs known as antivirals. It works by stopping the growth of the virus.

Cidofovir is not a cure for CMV retinitis, and your disease may still worsen during and after treatment.

Other uses

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used for herpes simplex virus infections that have not responded to other treatment.

How to use

This medication is given by injection into a vein as directed by your doctor, usually every 1 to 2 weeks. It is injected slowly into a vein over 1 hour. This medication should not be injected into the eyes. Permanent loss of vision may occur.

Dosage is based on your medical condition, body weight, and response to treatment. You will usually receive IV fluids before your dose of cidofovir. Your doctor will also direct you to take probenecid by mouth before and after you receive cidofovir. To prevent kidney problems, drink plenty of fluids unless otherwise directed by your doctor. This is especially important if you are vomiting or having diarrhea.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

It is very important to use the probenecid with this medication exactly as prescribed by your doctor. Nausea and vomiting due to probenecid may be prevented by taking it after meals. Your doctor may also prescribe another medication to prevent nausea, and may direct you to take antihistamines (such as diphenhydramine) and/or acetaminophen to prevent allergic reactions to probenecid.

Use this medication regularly to get the most benefit from it. To help you remember, mark your calendar with a reminder.

Do not use more or less of this drug than prescribed or stop using it (or your HIV medicines) even for a short time unless directed to do so by your doctor. Doing so may cause the amount of virus to increase, make the infection more difficult to treat (resistant), or worsen side effects.

Avoid direct contact of this medicine with the skin/eyes/mouth. If contact occurs, wash thoroughly with soap and water. For eyes, rinse with a steady stream of tap water for at least 5 minutes.

Side effects

See also Warning section.

Nausea may occur. Headache, nausea, and vomiting may occur with probenecid use. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • nausea/vomiting that doesn't stop
  • dark urine
  • swelling
  • loss of appetite
  • unusual tiredness/sluggishness
  • stomach/abdominal pain
  • muscle loss
  • signs of infection (such as sore throat/cough that doesn't go away, fever)
  • vision changes
  • new/increased eye redness or irritation
  • new/increased eye pain
  • mental/mood changes (such as confusion)
  • yellowing eyes/skin

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using cidofovir, tell your doctor or pharmacist if you are allergic to it; or to other antivirals (such as ganciclovir); or to probenecid; or to other sulfa drugs (such as sulfamethoxazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • diabetes
  • ganciclovir eye implant
  • kidney disease

This drug may cause vision changes. Do not drive, use machinery, or do anything that needs clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Older adults may be at a greater risk for kidney damage while using this drug.

During pregnancy, cidofovir should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. The manufacturer recommends avoiding pregnancy. To prevent pregnancy, men with female partners should use effective barrier protections (such as latex or polyurethane condoms) during all sexual activity during treatment and for at least 90 days after stopping the medication. Women should use effective forms of birth control (such as birth control pills and condoms) during treatment and for at least 1 month after stopping the medication.

It is unknown if this medication passes into breast milk. If you have HIV, breast milk may transmit HIV. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Avoid taking other medications that may damage your kidneys (such as amphotericin B, foscarnet, pentamidine, vancomycin, aminoglycosides including tobramycin, nonsteroidal anti-inflammatory drugs-NSAIDs including ibuprofen) within 7 days before and during treatment with this medication. In some cases, serious (possibly fatal) kidney damage may occur. See also Warning section.

Check the labels on all your medicines because they may contain NSAIDs (such as ibuprofen, naproxen). Ask your pharmacist about using those products safely.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: change in the amount of urine.

Notes

Lab and/or medical tests (such as eye exams) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

To decrease your risk of spreading HIV disease to others, use an effective barrier method (such as latex or polyurethane condoms/dental dams) during sexual activity. Consult your doctor or pharmacist for more details.

Missed dose

It is important to get each dose of this medication as scheduled. If you miss a dose of cidofovir, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up. If you miss a dose of the probenecid, tell your doctor or pharmacist right away. You may have to reschedule your cidofovir dose.

Storage

Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised November 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.