Cidofovir dosage

Intravenous cidofovir is effective for the treatment of CMV retinitis and is used experimentally to treat adenovirus infections. Intravenous cidofovir must be administered with high-dose probenecid (2 g at 3 hours before the infusion and 1 g at 2 and 8 hours after), which blocks active tubular secretion and decreases nephrotoxicity. Cidofovir dosage must be adjusted for alterations in the calculated creatinine clearance or for the presence of urine protein before each infusion, and aggressive adjunctive hydration is required. Initiation of cidofovir therapy is contraindicated in patients with existing renal insufficiency. Direct intravitreal administration of cidofovir is not recommended because of ocular toxicity. 

CMV retinitis in patients with AIDS [in combination with probenecid) IV infusion induction Usual dosage, 5 mg/kgat constant rate over 1 hr onceweeklyfor 2 consecutive wk. Give 2g of PO probenecid 3 hr before cidofovir dose, and then give 1 g 2 hr and 8 hr after completion of the 1 -hr cidofovir infusion (total of 4 g). in addition, give 1 L of 0.9% NaCl over 1-2 hr immediately before the cidofovir infusion, if tolerated, a second liter may be infused over 1 -3 hr at the start of the infusion or immediately afterward. Maintenance 5 mg/kg cidofovir at constant rate over 1 hr once every 2 wk. 

Cidofovir (pediatric dosage is not established) possibly effective... 

Probenecid reduces the nephrotoxicity of cidofovir, and it is recommended it should always be used concurrently. Therefore, when using cidofovir/probenecid the interactions of probenecid should be considered. Of particular note, zidovudine should be temporarily discontinued or the dosage halved when cidofovir/probenecid is used, see NRTIs + Probenecid , p.803. 

Cidofovir, marketed under the name Vistide. is distributed in vials containing 375 mg of the drug dissolved in 5 mL of water. The manufacturer specifies that the drug should be kept at room temperature (68°F-77°F). The vial contents are first diluted with saline and then administered intravenously with a recommended dosage of 5 mg cidofovir per kilogram of body weight. 

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