Comparative Pharmacology
Head-to-head clinical analysis: CIDOFOVIR versus REBETOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIDOFOVIR versus REBETOL.
CIDOFOVIR vs REBETOL
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, a guanosine analog, inhibits viral RNA-dependent RNA polymerase and inosine monophosphate dehydrogenase, leading to a decrease in intracellular guanosine triphosphate pools and impairment of viral RNA synthesis.
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.
Oral: 400-600 mg twice daily (800-1200 mg/day) based on body weight (≤75 kg: 400 mg twice daily; >75 kg: 600 mg twice daily) in combination with interferon alfa or peginterferon alfa.
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: 120-200 hours (multiple doses, due to extensive accumulation in erythrocytes). Single dose: 24-36 hours. Clinically, steady state is reached in approximately 4 weeks.
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%).
Renal: 10-15% unchanged; biliary/fecal: 60-70% as metabolites; pulmonary excretion of CO2 contributes to elimination of ribavirin's triazole moiety. Approximately 10-20% excreted in feces as unchanged drug and metabolites.
Category D/X
Category C
Antiviral
Antiviral