Cidofovir

Generic name
Cidofovir
Brand name
ATC Code
J05AB12
Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No specific kinetic studies have been published in children.

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

CMV infection, adenovirus infection in immunocompromised patients
  • Intravenous
    • 1 month up to 18 years
      • Initial dose: 1 mg/kg/dose 3 times a week. for 2 weeks. Infuse the cidofovir dose in 1 hour..
      • Maintenance dose: 1 mg/kg/dose 3 times a week every other week (one week on, one week off).. Infuse the cidofovir dose in 1 hour..

      • Only to be used by specialists who have experience with cidofovir.

        NOTE: In order to limit the nephrotoxicity, cidofovir is given combined with probenicid and hydration with physiological saline:
        Probenicid: 25 mg/kg/dose orally, 3 hours before starting the cidofovir infusion and 1-2 hours after and 8 hours after the cidofovir infusion
        Hydration: 0.58 l/m² 1 hour before the cidofovir infusion and if possible 0.58 l/m² administered simultaneously with or immediately after the cidofovir infusion in 1-3 hours.
Larynx papillomatosis
  • Intralesional
    • 1 month up to 18 years
      • Initial dose: 1 mg/kg/dose 3 times a week. For 2 weeks.
      • Maintenance dose: 1 mg/kg/dose 3 times a week every other week (one week on, one week off).

      • Alternative:
        Starting dose: 5 mg/kg once a week for 2 weeks,
        Maintenance: 5 mg/kg/dose every other week.

Renal impaiment in children > 3 months

when the creatinine clearance is 10-50 ml/min: If there are life-threatening indications, using cidofovir combined with probenicid can be considered in consultation with a paediatric nephrologist and hospital pharmacist. An adjusted dose must be individually determined. Consult the available literature: Yusuf 2006 for children; Brody 1999 for adults)

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Significant risk of nephrotoxicity. Cidofovir should only be administered in combination with probenicid and hydration with physiological saline.
Monitoring the renal function and virus concentration is a precondition for being able to evaluate the side effects and the effectiveness. Only administer under well-controlled conditions
 

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

DIRECT ACTING ANTIVIRALS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Nucleosides and nucleotides excl. reverse transcriptase inhibitors
J05AB01
J05AB06
J05AB16
J05AB04
J05AB11
J05AB14
Phosphonic acid derivatives
J05AD01
Protease inhibitors
J05AE08
J05AE10
J05AE07
J05AE02
J05AE04
J05AE03
J05AE01
Nucleoside and nucleotide reverse transcriptase inhibitors
J05AF06
J05AF02
J05AF09
J05AF10
J05AF05
J05AF04
J05AF07
J05AF13
J05AF13
J05AF01
Non-nucleoside reverse transcriptase inhibitors
J05AG06
J05AG03
J05AG04
J05AG01
J05AG05
Neuraminidase inhibitors
J05AH02
J05AH01
Antivirals for treatment of HIV infections, combinations
J05AR02
J05AR20
J05AR13
J05AR25
J05AR18
J05AR19
J05AR03
J05AR09
J05AR10
Other antivirals
J05AX28
J05AX12
J05AX07
J05AX09
J05AX08
J05AX24
ANTIVIRALS FOR TREATMENT OF HIV INFECTIONS, COMBINATIONS
J05AR02
J05AR20
J05AR13
J05AR25
J05AR18
J05AR19
J05AR03
J05AR09
J05AR10
Integrase inhibitors
J05AJ04
Antivirals for treatment of HCV infections
J05AP54
J05AP57
J05AP51
J05AP08
J05AP55

References

  1. Doan ML, et al, Treatment of adenovirus pneumonia with cidofovir in pediatric lung transplant recipients, J Heart Lung Transplant, 2007, Sep;26(9, 883-9
  2. Chhetri DK, et al, A scheduled protocol for the treatment of juvenile recurrent respiratory papillomatosis with intralesional cidofovir, Arch Otolaryngol Head Neck Surg, 2003, Oct;129(10, 1081-5
  3. Mandell DL, et al, Intralesional cidofovir for pediatric recurrent respiratory papillomatosis, Arch Otolaryngol Head Neck Surg, 2004, Nov;130(11), 1319-23
  4. Pransky SM, et al, Clinical update on 10 children treated with intralesional cidofovir injections for severe recurrent respiratory papillomatosis., Arch Otolaryngol Head Neck Surg, 2000, Oct;126(10), 1239-43
  5. Pransky SM, et al, Long-term follow-up of pediatric recurrent respiratory papillomatosis managed with intralesional cidofovir., Laryngoscope, 2003, Sep;113(9), 1583-7
  6. Doan ML, et al, Clinical, radiological and pathological features of ABCA3 mutations in children, Thorax, 2008, Apr;63(4), 366-73
  7. Anderson EJ, et al, Human intraparietal sulcus (IPS) and competition between exogenous and endogenous saccade plans., tNeuroimage., 2008, Apr 1;40(2):, 838-51
  8. Legrand F, et al, Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children, Bone Marrow Transplant., 2001, Mar;27(6), 621-6
  9. Ljungman P, et al, Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. The Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation, Blood, 2001, Jan 15;97(2), 388-92
  10. Yusuf U, et al, Cidofovir for the treatment of adenoviral infection in pediatric hematopoietic stem cell transplant patients, Transplantation, 2006, May 27;81(10), 1398-404
  11. Anderson EJ, et al, High-risk adenovirus-infected pediatric allogeneic hematopoietic progenitor cell transplant recipients and preemptive cidofovir therapy, Pediatr Transplant, 2008, Mar;12(2), 219-27
  12. Hoffman JA, et al, Adenoviral infections and a prospective trial of cidofovir in pediatric hematopoietic stem cell transplantation, Biol Blood Marrow Transplant, 2001, 7(7), 388-94
  13. Pransky SM, et al, Clinical update on 10 children treated with intralesional cidofovir injections for severe recurrent respiratory papillomatosis., Arch Otolaryngol Head Neck Surg, 2000, Oct;126(10), 1239-43
  14. Legrand F, et al, Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children, Bone Marrow Transplant., 2001, Mar;27(6), 621-6

Changes

Therapeutic Drug Monitoring


Overdose