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Nucleotide analogue antiviral

Cidofovir

Brand names: Vistide

Adult dose

Dose: Induction: 5mg/kg IV weekly for 2 weeks. Maintenance: 5mg/kg every 2 weeks. Each dose with probenecid + IV hydration

Route: IV

Frequency: weekly/q2w

Clinical pearls

CMV retinitis in AIDS — second-line. Mandatory probenecid and saline pre-hydration to reduce nephrotoxicity

Contraindications

Severe renal impairment
Hypersensitivity to probenecid/sulphonamides

Side effects

Nephrotoxicity (dose-limiting)
Neutropenia
Ocular hypotony
Metabolic acidosis

Interactions

Other nephrotoxic drugs (aminoglycosides, amphotericin, NSAIDs, foscarnet)

Monitoring

U&E and urinary protein before each dose
FBC
Visual acuity
IOP

Reference: BNF; https://bnf.nice.org.uk/drugs/cidofovir/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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