Cidofovir

Cidofovir 

  • Pregnancy Category C

Formulations

  • Topical as 1% and 3% cream, intralesional, intravenous 

Dosing 

  • Verruca Vulgaris
    • Intralesional: 15 mg / mL; max dose = 140 mg every month for 2-3 months (many need more)
    • 3% cream:  under occlusion once daily x 12 weeks

Acyclovir-resistant HSV (immunocompromised)

  • 1% cream or gel daily × 2–3 weeks
  • Severe: 5 mg/kg IV weekly x 2 doses then every 2 weeks (with probenecid)

Acyclic nucleotide, analog of deoxycytidine monophosphate; diphosphorylated in the cell and incorporated into DNA leading to inhibition of DNA polymerase

* importantly, does NOT depend on viral thymidine kinase for phosphorylation explaining its utilization in Acyclovir-resistant HSV

FDA

  • Cytomegalovirus retinitis (in AIDS patients) 

Off-label

  • Human papilloma virus, HSV (herpes simplex), molluscum contagiosum

Topical

  • Local skin reactions

Intravenous

  • Renal toxicity, iritis, neutropenia, gastrointestinal side effects, metabolic acidosis

* For further reading refer to a pharmacology source

Importantly, does NOT depend on viral thymidine kinase for phosphorylation