What should you do if you FORGET to receive bothersome, please call your doctor or CIDOFOVIR a dose? pharmacist.

Other NAMES: Vistide® Cidofovir will likely by given at a clinic by an Some adverse effects experienced by patients experienced nurse. Ensure that you do not miss treated with cidofovir may be related to WHY is this drug prescribed? your appointment to receive your dose of probenecid (Benuryl ). These adverse effects cidofovir. Missing doses of cidofovir may cause are skin rash, nausea, vomiting, headache, chills Cidofovir is an antiviral used for the treatment of your CMV infection to come back or worsen. If and fever. Eating food before taking probenecid cytomegalovirus (CMV) infection (ie: retinitis). you have missed an appointment, call your clinic helps reduce the risk of nausea and vomiting. The drug is also used to prevent a relapse of CMV immediately to rebook an appointment to receive Patients who experience a skin rash or itchiness after the initial treatment of the infection. You your dose as soon as possible. are usually given an antihistamine to reduce should have your eyes examined regularly. symptoms. Inform you doctor if you experience What ADVERSE EFFECTS can this drug intolerable adverse effects. HOW should this drug be taken? cause? What should you do about them? It is important that you keep your doctor Cidofovir is given intravenously every week for two The most serious and commonly reported appointments and come for your laboratory weeks and then on alternating weeks for an adverse effect of intravenous cidofovir is kidney tests so that your progress can be followed. indefinite period of time. The protocol for cidofovir toxicity . Your kidney status will be checked the administration is as follows: day before you receive an infusion of cidofovir. If What other PRECAUTIONS should you follow measurements of serum creatinine and protein in while using this drug?
2000 mg oral dose of probenecid (Benuryl ) (4 your urine are not within acceptable limits, your x 500 mg tablets) three hours prior to cidofovir doctor will either reduce your dose or discontinue Before starting cidofovir, please inform your therapy. Hydration with normal saline and doctor if you are allergic to cidofovir, probenecid
1 liter infusion of normal saline one hour prior to administration of oral probenecid (Benuryl ) help (Benuryl ) or any sulfa drug (Bactrim , Septra ). cidofovir to reduce the risk of kidney toxicity. If while handling the drug, it accidentally spills,
Cidofovir infusion over one hour . The Cidofovir can also cause a fall in the number of avoid contact with your skin, eyes, or mucous appropriate dose will depend on your weight and white blood cells . This can increase your risk of membranes (eg. nose). Wear rubber gloves while kidney function. developing infections as white blood cells are cleaning up any spills. If the drug comes in contact needed to fight infections. Cidofovir can also with your skin or mucous membranes, wash the
While cidofovir is infusing, another liter of decrease platelets . This can increase your risk area thoroughly with soap and water, and rinse normal saline may be given over 1 to 3 hours. of bleeding or bruising as platelets are needed to thoroughly with water. help your blood clot. Your red blood cells may
1000 mg (2 x 500 mg tablets) of probenecid also decrease which could make you feel tired or The duration of treatment with cidofovir is (Benuryl ) 2 hours after the cidofovir infusion is short of breath. Blood tests will be done regularly indefinite. This is true even if you begin to feel completed to check for any changes in these values. If there your vision is improving. are any serious problems, cidofovir will be
1000 mg (2 x 500 mg tablets) of probenicid stopped. Please Inform your doctor if you notice It is important to tell your doctor if you are (Benuryl ) 8 hours after the cidofovir infusion is any symptoms of fever, chills, shortness of pregnant. Cidofovir may cause birth defects to completed. breath, rapid heartbeat, fatigue, bleeding or your unborn child and should be used only if the bruising. risks of not treating CMV are greater than the risks to your child. Nausea, diarrhea, fatigue, fever, hair loss, and muscle pain can also occur as a result of If you are a woman with childbearing potential, cidofovir therapy. If these effects persist and are you should always use appropriate contraceptive methods (birth control pill, condom) to avoid becoming pregnant while you are taking cidofovir About an hour before your treatment, remove a and for 1 month following the end of the cidofovir bag from the refrigerator and let it warm to room treatment. If you are a man, you should use a temperature. Check your bag to ensure that condom during treatment with cidofovir and for at there are no leaks and that there are no solid least 3 months following the end of the particles in the solution. The solution should be treatment. In general, even if you are not taking clear and colorless. If not, you should not use the cidofovir, the use of condoms is always bag. recommended to decrease the risk of passing CIDOFOVIR HIV on to others. Probenecid (Benuryl ) tablets should be kept in a cool (15-30 °C) dry place, protected from light When given with cidofovir, many drugs may and well out of the reach of children. increase the risk of developing adverse effects. Inform your doctor and pharmacist if you are If you have any questions or concerns about taking the following drugs: this drug or if you are experiencing adverse effects, please discuss them with your - aminoglycoside antibiotics (gentamicin, pharmacist, doctor or nurse. tobramycin, amikacin,etc.)   - amphotericin B (Fungizone , Abelcet , Write questions or concerns down to ensure  Ambisome ) they are addressed.  - foscarnet (Foscavir ) MEDICATION - intravenous pentamidine (Pentacarinat ) The following pharmacist is available to answer - non-steroidal anti-inflammatory agents questions: (NSAIDS), e.g., ibuprofen (Advil , Motrin ), FACT SHEET naproxen (Naprosyn ) Pharmacist: ______- vancomycin Telephone: ______- zidovudine (Retrovir )

Probenecid (Benuryl ) may also interfere with many drugs.

Inform your doctor and pharmacist of all prescribed and non-prescribed drugs you are taking. As well, you should inform them of natural products you are taking. If you wish to start a new drug or natural product, please consult with your pharmacist before doing so.

How should this drug be STORED? Reference: Cidofovir (Vistide ) Prescribing Information. If you are to receive the cidofovir treatment at Gilead Sciences, Foster City, CA, USA, September 2000. home, the diluted cidofovir intravenous solution Prepared by the Ontario HIV Pharmacy Professional ° Specialty Group, 2003. Reviewed 2009. should be kept in the refrigerator (2 - 8 C). It is recommended that the solution be used within 24 Additional medication fact sheets and updates may be found hours of dilution. Keep well out of the reach of at: www.hivclinic.ca children.