- Renal impairment is the major toxicity of cidofovir.
- Cases of acute renal failure resulting in dialysis and/or contributing to death have occurred with as few as one or two doses of the drug.
- To reduce possible nephrotoxicity, intravenous prehydration (normal saline) and administration of probenecid must be used prior to each infusion of cidofovir.
- Renal function (serum creatinine and urine protein) must be monitored within 48 hrs prior to each dose and the dose should be monitored for changes in renal function as appopriate [See Dosage and Administration] (see monitoring recommendations).
- Contraindicated in patients receiving other nephrotoxic agents.
- Neutropenia has been observed in assoication with cidofovir treatment
- Neutrophil counts should eb monitored during cidofovir therapy
- Cidofovir is indicated only for treatment of CMV retinitis in patients with AIDS
- In animal studies, cidofovir was carcinogenic, teratogenic, and caused hypospermia
MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA
- Serum creatinine and urine protein monitored within 48 hours prior to each dose. Dose adjustment required for changes in renal functions.
- Neutrophils counts should be monitored during therapy.
Patient Counseling Information
Updated January 2018