Comparative Pharmacology
Head-to-head clinical analysis: CIDOFOVIR versus COPEGUS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIDOFOVIR versus COPEGUS.
CIDOFOVIR vs COPEGUS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Cidofovir is a nucleotide analog that inhibits viral DNA polymerase by competing with deoxycytidine triphosphate for incorporation into viral DNA, resulting in chain termination and inhibition of viral replication.
Ribavirin is a nucleoside analogue that inhibits viral RNA synthesis by interfering with RNA capping and polymerase activity, and may also modulate immune responses.
5 mg/kg intravenously once weekly for 2 weeks, then 5 mg/kg every 2 weeks. Administer with probenecid 2 g orally 3 hours before dose, then 1 g at 2 and 8 hours after dose. Hydrate with 1 L normal saline before infusion.
800 mg orally twice daily to 1200 mg orally twice daily based on body weight (≤75 kg: 800 mg; >75 kg: 1200 mg), in combination with ribavirin, for 24 to 48 weeks depending on genotype.
None Documented
None Documented
Clinical Note
moderateCidofovir + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Cidofovir."
Clinical Note
moderateTenofovir disoproxil + Cidofovir
"Tenofovir disoproxil may decrease the excretion rate of Cidofovir which could result in a higher serum level."
Terminal elimination half-life is approximately 2.5 hours. However, the intracellular half-life of the active diphosphate metabolite is >48 hours, supporting once-weekly dosing.
Terminal elimination half-life is approximately 120-170 hours following multiple doses, supporting once-daily dosing with prolonged viral suppression.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for approximately 90% of the administered dose. Biliary/fecal elimination is minimal (<5%).
Ribavirin is primarily eliminated renally as unchanged drug (61%) and metabolites (30%); biliary/fecal excretion accounts for ~9%.
Category D/X
Category C
Antiviral
Antiviral