Comparative Pharmacology
Head-to-head clinical analysis: CIDOFOVIR versus SYMADINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIDOFOVIR versus SYMADINE.
CIDOFOVIR vs SYMADINE
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.
SYMADINE (amantadine) is a tricyclic amine that inhibits influenza A virus replication by blocking the viral M2 ion channel, which prevents uncoating of viral RNA. It also increases dopamine release and inhibits dopamine reuptake in the CNS, providing antiparkinsonian effects.
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.
100 mg orally every 12 hours; immediate-release formulation.
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.
The terminal elimination half-life is approximately 24 hours in patients with normal renal function. In patients with renal impairment (CrCl <50 mL/min), the half-life is significantly prolonged, requiring dose adjustment. The long half-life allows for once-daily dosing.
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 elimination of unchanged drug accounts for approximately 90% of the administered dose. Biliary/fecal excretion is minimal (<5%).
Category D/X
Category C
Antiviral
Antiviral and Antiparkinsonian