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Overview: Cidofovir is used to treat a viral eye infection called cytomegalovirus retinitis in people with AIDS. It prevents the virus from multiplying in the body. Common side effects include kidney damage, low neutrophil levels, eye problems, fever, and infection. This medicine is given to you as an infusion into a blood vessel by a health care provider. Contact your health care provider right away if you have fever, signs of infection, vision changes, reduced need to pee, or unusual tiredness.

Uses

What is cidofovir used for?

Cidofovir is commonly used to treat cytomegalovirus (CMV) retinitis, a viral eye infection, in people with AIDS.

Cidofovir may not be appropriate for the infection listed above, depending on which germs are causing the infection. Viruses in some locations may have developed resistance to cidofovir, which will make it not work as well.

Cidofovir may also be used for other conditions as determined by your health care provider.

How does cidofovir work (mechanism of action)?

Cidofovir prevents cytomegalovirus from multiplying in the body by disrupting its ability to create DNA.

How is cidofovir supplied (dosage forms)?

Brands and other names

  • Vistide

Dosage forms and strengths

Cidofovir is available in an injectable form that is given by a health care provider.

How should I store cidofovir?

Cidofovir is usually given by a health care provider in a hospital or clinic. If you will store cidofovir at home, follow the instructions given by your health care provider.

Side Effects

What are the most common side effects of cidofovir?

The most common side effects of cidofovir are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Kidney damage (see below)
  • Low neutrophil levels (see below)
  • Eye problems (see below)
  • Metabolic acidosis (see below)
  • Fever
  • Infection

There may be other side effects of cidofovir that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of cidofovir?

While less common, the most serious side effects of cidofovir are described below, along with what to do if they happen.

Severe Allergic Reactions. Cidofovir may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Kidney Damage. Kidney damage can happen when using cidofovir. Keep all appointments, including lab appointments. Your health care provider needs blood tests to make sure that you can safely take this medicine. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Low Neutrophil Levels (Neutropenia). Cidofovir may cause low levels of a type of white blood cell (called neutrophils), which is known as neutropenia. Neutrophils help prevent infection. Having a low level of neutrophils may increase your risk of infection. Tell your health care provider right away if you have any of the following symptoms of low neutrophil levels.

  • Fever, chills, or sweats
  • Tiredness
  • Sore throat, cough, or shortness of breath
  • Mouth or throat sores
  • Swollen lymph nodes

Eye Problems. Cidofovir may cause uveitis, which is inflammation of the middle layer of the eyes. It may also cause iritis, which is a specific type of uveitis that affects the colored part of the eyes. Cidofovir may also cause decreased pressure inside the eyes. Your health care provider will monitor the pressure inside your eyes during treatment with cidofovir. Attend all appointments to have your eyes checked. Tell your health care provider right away if you have any of the following symptoms.

  • Blurred or double vision
  • Eye pain or redness
  • Sensitivity to light
  • Vision loss

Metabolic Acidosis. Cidofovir can cause a condition called metabolic acidosis. This happens when there is too much acid in your blood. If this condition is not treated, it can cause kidney stones, slow growth in children, or harm to your fetus if you are pregnant. Your bones can also become soft or brittle (osteoporosis, osteomalacia [rickets], osteopenia). Tell your health care provider right away if you have any of the following symptoms of metabolic acidosis.

  • Fast breathing or heartbeat
  • Headache
  • Feeling confused, weak, or tired
  • Not feeling hungry
  • Nausea or vomiting

Warnings & Precautions

Who should not use cidofovir?

Allergies to Ingredients. People who are allergic to any of the following should not use cidofovir.

  • Cidofovir
  • Vistide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific cidofovir products they stock.

Kidney Problems. Cidofovir should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to determine if they are working well enough to use this medicine.

Drug Interactions. Cidofovir should not be used while you are using certain other medicines. Before using cidofovir, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Sulfa Allergy. People who have had a serious allergic reaction to probenecid or other sulfa-containing medicines should not use cidofovir. A sulfa allergy is a rash or more serious reaction to sulfa, or sulfonamide, medicines. Sulfa medicines include sulfamethoxazole, sulfadiazine silver, or sulfasalazine.

What should I know about cidofovir before using it?

Cidofovir is usually given by a health care provider in a hospital or clinic.

You should stay well hydrated by drinking plenty of water while using cidofovir.

You may be prescribed a medicine called probenecid to take while you are using cidofovir. Take it as prescribed. Probenecid can cause side effects including headache, nausea, vomiting, and allergic reactions, which can be severe. Contact your health care provider right away if you have a rash, fever, chills, or other symptoms of an allergic reaction while taking probenecid.

People who can get pregnant should use effective birth control during treatment with cidofovir and for one month after finishing treatment. People who can get a partner pregnant should use barrier contraception (such as a condom) during treatment with cidofovir and for three months after finishing treatment.

Cidofovir may make it difficult for you to get pregnant or get your partner pregnant. If you have concerns, talk to your health care provider.

Cidofovir may increase the risk of developing cancer. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using cidofovir?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if cidofovir is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney problems
  • Low neutrophil levels 
  • Eye problems
  • Diabetes mellitus

Pregnancy. It is not known if or how cidofovir could affect pregnancy or harm a fetus. Cidofovir causes birth defects in animals and may cause birth defects in humans. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use cidofovir while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if cidofovir passes into breast milk. Do not breastfeed while receiving cidofovir. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does cidofovir interact with foods or drinks?

There are no known interactions between cidofovir and foods or drinks.

There are no known interactions between cidofovir and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight infection.

Does cidofovir interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using cidofovir.

  • An aminoglycoside antibiotic, such as amikacin, gentamicin, or tobramycin, which is used to treat various infections
  • Amphotericin B (Abelcet, AmBisome), which is a medicine used to treat certain fungal infections
  • Foscarnet, which is a medicine used to treat CMV retinitis
  • Vancomycin (Firvanq, Vancocin), which is an antibiotic used to treat various infections
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever

This may not be a complete list of medicines that can interact with cidofovir. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much cidofovir?

If you or someone else has used too much cidofovir, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of cidofovir?

Cidofovir is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving cidofovir as scheduled.

If you miss an appointment to get your cidofovir dose, call to make another appointment as soon as possible.