Comparative Pharmacology
Head-to-head clinical analysis: CIDOFOVIR versus ZIRGAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIDOFOVIR versus ZIRGAN.
CIDOFOVIR vs ZIRGAN
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.
Ganciclovir is a synthetic guanine derivative that inhibits cytomegalovirus (CMV) replication by competitively inhibiting viral DNA polymerase (UL54) and by incorporating into viral DNA, causing chain termination. Ganciclovir is phosphorylated to ganciclovir triphosphate by viral thymidine kinase (UL97) in CMV-infected cells.
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.
Instill 1 drop (approximately 0.05 mL) into affected eye(s) 5 times daily (approximately every 3 hours while awake) until corneal ulcer heals, then reduce to 1 drop 3 times daily for 7 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.
Terminal elimination half-life in patients with normal renal function is approximately 3-4 hours; in renal impairment, half-life may be prolonged up to 30 hours, requiring dose adjustment.
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%).
Primarily renal excretion as unchanged drug via glomerular filtration and tubular secretion; >90% of a systemically absorbed dose is recovered unchanged in urine.
Category D/X
Category C
Antiviral
Antiviral