Cidofovir
Cidofovir is an antiviral medication used primarily to treat cytomegalovirus (CMV) retinitis, a serious eye infection that can lead to blindness in immunocompromised patients, particularly those with AIDS. It works as a nucleotide analog that inhibits viral DNA synthesis, preventing the virus from replicating. This medication is typically reserved for patients who cannot tolerate or have not responded to other treatments.
Cidofovir is an antiviral injection used to treat CMV eye infections in immunocompromised patients like those with AIDS, working by inhibiting viral DNA synthesis.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- J05AB12
- RxNorm
- 83171
- Generic
- Cidofovir
- Class
- atc-j05
- Brands
- —
- Availability
- rx
- Pregnancy
- C
- Lactation
- caution
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
11 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring and ultrasound assessments
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring and assessment of fetal well-being
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid
discontinue breastfeeding or avoid use of cidofovir
no data available on excretion in breast milk
renal_impairment
mild moderaterequired
reduce dose to 1 mg/kg for CrCl 30-55 mL/min; contraindicated for CrCl <30 mL/min without nephrotoxicity
monitor serum creatinine and urine protein before each dose; monitor renal function weekly
Use with caution and monitor for adverse effects.
renal_impairment
severecontraindicated
contraindicated in patients with CrCl <55 mL/min or serum creatinine >1.5 mg/dL
Use of this medication in this population requires careful consideration of risks and benefits.
hepatic_impairment
mildno specific adjustment
use with caution; limited data available
monitor liver function tests
Use with caution and monitor for adverse effects.
hepatic_impairment
moderate severeinsufficient data
use with extreme caution; limited clinical experience
close monitoring of liver function and clinical status
Use with caution and monitor for adverse effects.
pediatric_age
under 2 yearsinsufficient data
use only in life-threatening situations; safety and efficacy not established in children <2 years
monitor renal function closely; limited pediatric dosing data
Use with caution and monitor for adverse effects.
pediatric_age
2 to 18 yearsinsufficient data
use with caution; pediatric dosing not well established
monitor renal function and for adverse effects
Use with caution and monitor for adverse effects.
geriatric
over 65 yearsassess renal function
use with caution due to age-related decline in renal function; assess renal function before dosing
monitor renal function closely before each dose; may have increased sensitivity
Use with caution and monitor for adverse effects.
Statistics and clinical data
FDA approval year
Initial FDA approval for CMV retinitis in AIDS patients
Drug class
Antiviral agent classification
Primary indication
Main therapeutic use in immunocompromised patients
Mechanism of action
Antiviral mechanism of action
Treatment of CMV retinitis in immunocompromised patients, particularly those with AIDS. It may also be used for other CMV infections in patients who cannot tolerate or are refractory to standard treatments like ganciclovir or foscarnet.
Cidofovir is a nucleotide analog that is converted intracellularly to its active form. It inhibits viral DNA polymerase, which is essential for CMV replication, thereby preventing the virus from multiplying and spreading.
Cidofovir is administered by intravenous infusion, typically once weekly initially then every two weeks for maintenance. It carries a significant risk of nephrotoxicity (kidney damage), requiring regular monitoring of kidney function. Probenecid and adequate hydration are given alongside to reduce kidney toxicity. It is contraindicated in patients with pre-existing renal impairment. Other serious side effects may include neutropenia and metabolic abnormalities.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy