1. Product Description
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Brand Name: Cidnavir
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Generic Name: Cidofovir
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Drug Class: Antiviral (Nucleotide analog)
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Manufacturer: (Varies by country; often available as a specialty pharmaceutical product)
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Dosage Form: Intravenous (IV) solution (typically 375 mg/vial for reconstitution)
2. Composition
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Active Ingredient: Cidofovir (as cidofovir hydrate)
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Inactive Ingredients: May include sterile water for injection, sodium hydroxide (for pH adjustment)
3. Therapeutic Uses
FDA/EMA-Approved Indications:
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Treatment of cytomegalovirus (CMV) retinitis in AIDS patients (second-line therapy)
Off-Label/Investigational Uses:
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Adenovirus infections (in immunocompromised patients)
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Herpesvirus infections (e.g., refractory HSV or VZV)
Mechanism of Action:
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Inhibits viral DNA polymerase, preventing viral replication.
4. Dosage & Administration
Standard Adult Dose for CMV Retinitis:
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Induction: 5 mg/kg IV once weekly for 2 weeks (with probenecid and saline hydration).
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Maintenance: 5 mg/kg IV every 2 weeks (with probenecid).
Key Administration Notes:
✔ Must be given with:
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Probenecid (to reduce nephrotoxicity)
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IV saline hydration (before and after infusion)
✔ Infusion rate: Slow IV over 1 hour.
✔ Dose adjustment required for renal impairment.
5. Contraindications
❌ Severe renal impairment (CrCl ≤ 55 mL/min)
❌ Hypersensitivity to cidofovir or probenecid
❌ Concurrent use with nephrotoxic drugs (e.g., furosemide, aminoglycosides)
6. Side Effects
Common | Serious (Require Immediate Action) |
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Nephrotoxicity (↑ creatinine) | Severe kidney failure |
Neutropenia | Uveitis/eye inflammation |
Nausea/vomiting | Metabolic acidosis |
Probenecid-related reactions (rash, headache) | Hypotension during infusion |
7. Storage & Handling
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Unopened vials: Store at 2–8°C (refrigerate).
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After reconstitution: Use within 24 hours if refrigerated.
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Protect from light.
8. Black Box Warnings (FDA)
⚠ Nephrotoxicity: Can cause permanent kidney damage.
⚠ Must administer with probenecid and hydration.
⚠ Carcinogenic/mutagenic potential (avoid in pregnancy).
9. Drug Interactions
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Nephrotoxic drugs (e.g., NSAIDs, vancomycin): ↑ Risk of kidney injury.
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Zidovudine: May ↑ toxicity.
10. Patient Counseling Points
✔ Report decreased urine output or eye pain immediately.
✔ Complete probenecid dosing as prescribed.
✔ Avoid pregnancy (teratogenic risk).
Note:
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Cidnavir is a high-alert medication used only in hospital/specialty settings.
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Confirm local availability and protocols (may differ by country).
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