【名 称】 化学名：西多福韦
英文名：cidofovir
商品名：Vistide （西多福韦注射液）
规格： 375mg/5ml
药品类别： 抗病毒类 

  
药理药动
Classification: Antiviral drug Action/Kinetics: A nucleotide analog that suppresses CMV replication by selective inhibition of viral DNA synthesis.
The drug inhibits CMVDNApolymease.Mustbeadministered with probenecid.
适 应 症
Treatment of CMV retinitis in clients with AIDS.
用法用量
IV Infusion CMV retinitis. Induction: 5 mg/kg given once weekly for 2 consecutive weeks as an IV infusion at a constant rate over 1 hr. Maintenance: 5 mg/kg given once q 2 weeks as an IV infusion at a constant rate over 1 hr. With each dose ofcidofovir, probenecid, 2 g PO, must be given 3 hr prior to the cidofovir dose and 1 g PO given at 2 hr and again at 8 hr after completion of the 1-hr cidofovirinfusion. Also, with each dose of cidofovir, the client should receive a total of 1 L of 0.9% NaCl solution IV over a 1- to 2-hr period just beforethecidofovirinfusion. If the client can tolerate it, give a second liter of 0.9% NaCl solution either at the start of the cidofovir infusion or immediately afterward and infuse over a 1- to 3-hr period. If serum creatinine increases by 0.3 to 0.4 mg/dL, reduce the dose of cidofovir from 5 to 3 mg/kg. Discontinue cidofovir if the serum creatinine increases by 0.5 mg/dL or more or if there is development of 3 + or more proteinuria.
不良反应
Renal / GU: Nephrotoxicity, Fanconi's syndrome and decreases in serum bicarbonate associated with renal tubular damage, proteinuria,elevatedserumcreatinine, glycosuria, hematuria, urinary incontinence, UTI, acute renal failure. GI: N&V, diarrhea, anorexia, abdominalpain,colitis,constipation,tonguediscoloration,dyspepsia,dysphagia,flatulence,gastritis,hepatomegaly,abnormalliverfunctiontests,melena,oralcandidiasis, rectal disorder, stomatitis, aphthousstomatitis, mouth ulceration, dry mouth.
CNS:Headache,asthenia,amnesia,anxiety,confusion,convulsionsdepression,dizziness,abnormalgait,hallucinations,insomnia,neuropathy,paresthesia,somnolence. CV: Hypotension, postural hypotension,pallor, syncope, tachycardia, vasodilation. Hematologic:Neutropenia,granulocytopenia,thrombocytopenia,anemia.Respiratory:Asthma,bronchitis,coughing, dyspnea, hiccup, increased sputum, lung disorder, pharyngitis,pneumonia,rhinitis,sinusitis.Dermatologic: Alopecia, rash, acne, skin discoloration,dryskin, herpes simplex, pruritus, rash, sweating, urticaria. Musculoskeletal: Arthralgia, myasthenia, myalgia. Metabolic: Edema, dehydration, weight loss. Ophthalmic: Ocularhypotony,amblyopia,conjunctivitis, eye disorder, iritis, retinal detachment, uveitis, abnormal vision. Miscellaneous: Allergic reactions, facial edema, malaise, back pain, chest pain, neck pain, sarcoma, sepsis fever, infections, chills, taste perversion.
注意事项
Pregnancy Category: C Contraindications: History of severe hypersensitivity to probenecid or other sulfa-containing drugs. Use by direct intraocular injection. Use in clients with a serum creatinine greater than 1. 5 mg/dL, a calculated CCR of 55 mL/min or less, or a urine protein of 100 mg/dL or more (equivalent to 2+ proteinuria or more). Lactation.
Special Concerns: Safety and efficacy have not been determined for children or for treatment of other CMV infections,includingpneumonitis,gastroenteritis, congenital or neonatal CMV disease, or CMV disease in non-HIV-infected clients. Increased risk ofocular hypotony in those with preexisting diabetes. Use caution in clients with risk factors for nephrotoxicity.
药物相互作用
Amphotericin B / ↑RiskofnephrotoxicityAminoglycosides / ↑ Risk of nephrotoxicity Foscarnet / ↑ Risk of nephrotoxicity Pentamidine, IV / ↑ Risk of nephrotoxicity Zidovudine / ↓ Zidovudine clearance