Cidofovir Injection (patient information)

IMPORTANT WARNING
Cidofovir can cause kidney damage. Some people have had kidney failure after taking only one or two doses of cidofovir. These people have needed dialysis or have died. Your doctor will order laboratory tests to check your kidney function within 48 hours before each infusion of cidofovir. Your doctor will adjust the dose of cidofovir according to your kidney function.

Tell your doctor if you are taking any other medications that cause kidney damage, some of which include amikacin (Amikin), amphoteracin B (Fungizone), foscarnet (Foscarvir), gentamicin (Garamycin), pentamidine (Pentam 300), tobramycin (Nebcin), vancomycin (Vancocin) and non-steroidal anti-inflammatory agents (Advil, Aleve, others). You must stop taking these medications at least 7 days before starting to take cidofovir. Be sure to tell your doctor about all drugs, over-the-counter medicines and herbal products you are taking.

Talk to your doctor about taking cidofovir with extra fluids and probenecid.

Cidofovir can cause a decrease in the number of a certain type of white blood cell. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to cidofovir.

Cidofovir should be used only for the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS).

Cidofovir has been shown to cause cancer, birth defects, and problems with sperm production in animals.

Talk to your doctor about the possible risks of taking this drug.

About your treatment
Your doctor has ordered cidofovir, an antiviral agent, to help treat your infection. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 1 hour, weekly, or every 2 weeks.

Cidofovir is used to treat CMV retinitis in patients with AIDS.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Precautions
Before administering cidofovir:


 * tell your doctor and pharmacist if you are allergic to cidofovir or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially those listed in the IMPORTANT WARNING section, antibiotics, zidovudine, and vitamins.
 * tell your doctor if you have or have ever had kidney or liver disease or diabetes.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cidofovir, call your doctor. Women of childbearing age should use an effective method of birth control during therapy and for 1 month following therapy.
 * Men should continue using condoms as standard precaution against spreading HIV disease.
 * Men should talk to their doctor about any attempt to conceive a child.

Administering your medication
Before you administer cidofovir, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Minor side effects
Cidofovir may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:


 * headache
 * diarrhea
 * stomach pain, upset or vomiting
 * constipation
 * sore mouth or tongue
 * joint and muscle pain
 * coughing
 * fever and chills

Severe side effects
If you experience either of the following symptoms, call your health care provider immediately:


 * skin rashes and itching of the skin
 * eye pain and redness, sensitivity to light, and decreased vision

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storing your medication
Your health care provider may give you one dose at a time; store it as directed. You will be told to store the doses in the refrigerator or freezer. Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature. If you are told to store additional cidofovir in the freezer, always move a 24-hour supply to the refrigerator for the next day's use. Do not refreeze medications.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving cidofovir in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:


 * tenderness
 * warmth
 * irritation
 * drainage
 * redness
 * swelling
 * pain

Brand names

 * Vistide®