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Author: Anoma Ranaweera, Medical Writer. Chief Editor: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, September 2015.
Cidofovir (Gilead Sciences; California, USA) is a potent antiviral drug that has been approved for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome (AIDS) due to infection with human immunodeficiency virus (HIV).
Several small studies and case reports describe the successful use of cidofovir applied either topically or by intralesional injection in virally-induced skin diseases.
Cidofovir is not marketed in New Zealand.
Non-approved reported uses of cidofovir in dermatology include:
Viral warts in anogenital skin are caused by human papillomavirus (HPV) Types 6 and 8, and at times, Types 16 and 18.
Recurrent respiratory papillomatosis is a condition characterised by viral warts in the upper airway.
Common warts (also known as verrucae) are also due to infection with subtypes of HPV. The plantar area (the sole of the foot) is one of the most frequent locations.
Kaposi sarcoma is associated with infection with Kaposi sarcoma herpesvirus (KSHV) also called human herpesvirus type 8.
Molluscum contagiosum is a common viral skin infection of infants and young children. Adolescents and adults are less often infected.
Cidofovir suppresses cytomegalovirus (CMV) replication by selective inhibition of viral DNA synthesis.
Concomitant use of other nephrotoxic drugs (e.g. aminoglycosides, amphotericin B, foscarnet, IV pentamidine, vancomycin, nonsteroidal anti-inflammatory agents) is contraindicated since it may result in an increased risk of nephrotoxicity
There is no evidence of pharmacokinetic interactions of cidofovir with probenecid.
In humans, systemic adverse reactions after topical or intralesional administration of cidofovir have been reported in a single patient with laryngeal papillomatosis who experienced chest pain after treatment with intralesional cidofovir.
Other potentially serious adverse effects with parenteral cidofovir include:
The safety and efficacy of cidofovir have not been evaluated in adults >60 years of age.
If you are not based in New Zealand, we suggest you refer to your national drug approval agency for further information about medicines (eg, the Australian Therapeutic Goods Administration and the US Food and Drug Administration) or a national or state-approved formulary (eg, the New Zealand Formulary and New Zealand Formulary for Children and the British National Formulary and British National Formulary for Children).
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