Comparative Pharmacology
Head-to-head clinical analysis: CIDOFOVIR versus VEKLURY.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIDOFOVIR versus VEKLURY.
CIDOFOVIR vs VEKLURY
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.
Remdesivir is a nucleotide analog prodrug that, after intracellular metabolism, incorporates into nascent viral RNA chains causing synthesis termination and inhibition of RNA-dependent RNA polymerase (RdRp). It targets the SARS-CoV-2 RdRp with selectivity over human RNA polymerases.
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.
200 mg IV on Day 1, then 100 mg IV once daily for 5 to 10 days.
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.
Remdesivir: ~1 hour (parent); GS-441524: ~27 hours (terminal). Context: GS-441524 accumulation may occur with 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: 10% unchanged remdesivir; 49% as metabolite GS-441524; 18% as other metabolites. Fecal: 47.5% as metabolites. Biliary: minor.
Category D/X
Category C
Antiviral
Antiviral