Nephrotoxicity can be reduced by co-administration with iv fluids and probenecid the dosing regimen for the latter is 2g po 3 hours prior to the dose, then 1 g po 2 hours and 8 hours after. How does probenecid reduce cidofovir nephrotoxicity? Renal clearance of cidofovir therefore exceeds the corresponding GFR.
The relatively slow secretion of cidofovir into the tubular lumen, in comparison to uptake from the blood, results in a long intracellular half-life of the drug in the proximal tubular cells which appears to underlie the nephrotoxicity. Probenecid, by inhibiting the organic anion transporter, prevents tubular uptake and protects the kidneys.
This was demonstrated nicely in a pilot study in HIV patients. Probenecid is a banned drug for athletes for a related reason — because it blocks entry of certain drugs into the urine, it has been used as a masking agent for other banned performance-enhancing drugs including steroids. AKI David Leaf drugs nephrotoxicity.
David Leaf. Postinflammatory hyperpigmentation and transient alopecia on the bearded area have also been observed. Adverse events reported with cidofovir and concurrent probenecid include constitutional reactions, such as fever, chills, nausea, vomiting, fatigue, headache, gastrointestinal upset and rash.
Administer 1 liter of 0. Probenecid and prehydration helps to provide renal protection. Tubular secretion of cidofovir is blocked by probenecid, leading to less accumulation in renal tubular cells, faster elimination of the drug from the kidney, and overall decreased exposure of the kidney to the drug. Children: Only use when the potential benefits of the drug outweigh the risks long-term carcinogenic and reproductive toxicity.
Increase in serum creatinine of 0. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. Give a list of all your medicines to any healthcare provider who treats you.
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Top of the page. What is the most important information I should know about cidofovir? What is cidofovir? What should I discuss with my health care provider before receiving cidofovir? You should not receive cidofovir if you are allergic to it, or if you have:. How is cidofovir given? The oral probenecid may be taken with food if it upsets your stomach.
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