Vistide
cidofovir
Cidofovir
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
What Vistide is and what it is used for
Before you use Vistide
How to use Vistide
Possible side effects
How to store Vistide
Further information
Medicinal product no longer authorised
The safety and efficacy of Vistide has not been demonstrated in diseases other than CMV retinitis in patients with AIDS.
Vistide must be administered by a healthcare professional (doctor or nurse) in a hospital setting.
CMV retinitis is an eye infection caused by a virus named cytomegalovirus (CMV). CMV attacks the retina of the eye and may cause loss of vision, and eventually lead to blindness. Patients with AIDS are at high risk of developing CMV retinitis or other forms of CMV disease such as colitis (an inflammatory bowel disease). Treatment for CMV retinitis is necessary to reduce the potential for blindness.
Vistide is an antiviral medicine which blocks the replication of CMV by interfering with viral DNA production.
If any of these apply to you, talk to your doctor. You are not to be given Vistide.
Tell your doctor if you have diabetes mellitus. Vistide should be used with caution in diabetic patients due to the potential increased risk of developing low pressure in the eye (ocular hypotony).
Vistide caused reduced testes weight and low sperm count (hypospermia) in animals. Although not observed in human studies of Vistide, such changes may occur in humans and cause infertility. Men should practice barrier birth control methods during and for 3 months after treatment with Vistide.
Vistide is not used for the treatment of HIV infection. Vistide will not stop you passing HIV infection onto other people so you should continue to take precautions to avoid infecting others.
Medicinal product no longer authorised
Vistide has not been studied in children. Therefore, this medicine should not be used in children. Using other medicines
These include:
tenofovir containing medicines, used to treat HIV-1 infection and/or chronic hepatitis B infection
aminoglycosides, pentamidine or vancomycin (for bacterial infections)
amphotericin B (for fungal infection)
foscarnet (for viral infection)
adefovir (for HBV infection)
These medicines must be stopped at least 7 days before taking Vistide.
Probenecid may interact with other medicines commonly used in the treatment of AIDS and AIDS-related illnesses, such as zidovudine (AZT). If you are taking zidovudine, you should discuss with your doctor whether to temporarily stop taking zidovudine or decrease the dose of zidovudine by 50% on days when Vistide and probenecid are given.
The potential for interactions between Vistide and anti-HIV protease inhibitors has not been studied.
Medicinal product no longer authorised
Vistide may cause short-term side effects such as fatigue or weakness. If you drive or operate machinery, discuss this with your doctor to get their advice about stopping these activities based upon your disease and your tolerance of the medicine.
This medicine contains 2.5 mmol (or 57 mg) sodium per vial which should be taken into consideration if you are on a controlled sodium diet.
The doctor or nurse will transfer the appropriate dose of Vistide from the vial to an infusion bag containing 100 ml 0.9% (normal) saline solution. The entire volume of the bag will be infused into your vein at a constant rate over a period of 1 hour using a standard infusion pump. The recommended dose, frequency of use, or rate of infusion must not be exceeded. At the end of this leaflet, there is further information for healthcare professionals on how to administer Vistide.
The dose you will need is calculated based on your body weight.
Starting (induction) treatment
The recommended dose of Vistide in patients with normal kidney function is 5 mg per kg of body weight given once weekly for two consecutive weeks.
Maintenance treatment
Beginning two weeks after completion of induction treatment, the recommended maintenance dose of Vistide in patients with normal kidney function is 5 mg per kg of body weight given once every two weeks.
Dose adjustment
If you have accidentally been given more Vistide than prescribed for you, tell your doctor immediately.
Medicinal product no longer authorised
Time | Dose |
3 hours before start of Vistide infusion | 2 g probenecid |
2 hours after end of Vistide infusion | 1 g probenecid |
8 hours after end of Vistide infusion | 1 g probenecid |
Total | 4 g probenecid |
Probenecid is only taken on the same day that Vistide is given.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
Like all medicines, Vistide can cause side effects, although not everybody gets them.
These side effects usually disappear when treatment with Vistide is stopped. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist immediately.
The most common side effect observed with Vistide is damage to the kidneys.
(These can affect more than 1 user in 10)
low white blood cell counts, headache, nausea, vomiting, protein in the urine, increase in blood creatinine (a measure of kidney function), hair loss, rash, weakness/fatigue and fever.
(These can affect 1 to 10 users in 100)
inflammation of the eye, reduced pressure in the eyes, difficult or laboured breathing, shortness of breath, diarrhoea and chills.
Additional reactions reported from post-marketing experience include kidney failure, damage to kidney tubule cells, inflammation of the pancreas and hearing impairment.
(These can affect more than 1 user in 10)
nausea, vomiting, rash and fever.
(These can affect 1 to 10 users in 100)
Medicinal product no longer authorised
headache, weakness/fatigue, chills and allergic reactions.
To reduce the risk of nausea and/or vomiting associated with taking probenecid, you should eat food before each dose. Your doctor might instruct you to take other medicines such as anti-emetics (anti sickness medicines), antihistamines and/or paracetamol to decrease the side effects of probenecid.
Probenecid may also cause other side effects including loss of appetite, sore gums, flushing, hair loss, dizziness, reduced red blood cell count and increased frequency of passing water (urinating). Allergic reactions, with skin inflammation, itching, hives and, rarely, severe allergic reactions, and serious skin reaction have occurred. There have been reports of reduced white blood counts, liver toxicity, kidney toxicity and destruction of red blood cells. Reductions in blood cell and platelet counts have also occurred.
Therefore before giving you probenecid your doctor should consult the current prescribing information regarding the safety of probenecid. You should also read the probenecid package leaflet.
Keep out of the reach and sight of children.
Do not use Vistide after the expiry date which is stated on the label. Do not store above 30°C. Do not refrigerate or freeze.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
Sodium hydroxide
Hydrochloric acid
Water for injections
Vistide is supplied as a sterile concentrate for solution for infusion in clear, glass vials containing 375 mg of the active ingredient, anhydrous cidofovir, formulated in 5 ml water for injections at a
concentration of 75 mg/ml. The formulation is pH-adjusted with sodium hydroxide (and hydrochloric acid if needed) and contains no preservatives.
CB21 6GT
United Kingdom
Medicinal product no longer authorised
Gilead Sciences Limited
IDA Business & Technology Park Carrigtohill Co. Cork
Ireland
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder.
Gilead Sciences Belgium BVBA Tél/Tel: + 32 (0) 24 01 35 79
Gilead Sciences International Ltd
Тел.: + 44 (0) 20 7136 8820
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences Sweden AB Tlf: + 46 (0) 8 5057 1849
Gilead Sciences Netherlands B.V. Tel: + 31 (0) 20 718 3698
Gilead Sciences GmbH Tel: + 49 (0) 89 899890-0
Gilead Sciences Sweden AB Tlf: + 46 (0) 8 5057 1849
Gilead Sciences Sweden AB Tel: + 46 (0) 8 5057 1849
Gilead Sciences GesmbH Tel: + 43 1 260 830
Gilead Sciences Ελλάς Μ.ΕΠΕ. Τηλ: + 30 210 8930 100
Gilead Sciences Poland Sp. z o. o. Tel: + 48 22 262 8702
Gilead Sciences, S.L. Tel: + 34 91 378 98 30
Gilead Sciences, Lda. Tel: + 351 21 7928790
Gilead Sciences
Tél: + 33 (0) 1 46 09 41 00
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences Ltd
Tel: + 44 (0) 1223 897555
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences Sweden AB Sími: + 46 (0) 8 5057 1849
Gilead Sciences International Ltd Tel: + 44 (0) 20 7136 8820
Gilead Sciences S.r.l. Tel: + 39 02 439201
Gilead Sciences Sweden AB Puh/Tel: + 46 (0) 8 5057 1849
Medicinal product no longer authorised
Gilead Sciences Ελλάς Μ.ΕΠΕ. Τηλ: + 30 210 8930 100
Gilead Sciences Sweden AB Tel: + 46 (0) 8 5057 1849
Gilead Sciences Sweden AB Tel: + 46 (0) 8 5057 1849
Gilead Sciences Ltd
Tel: + 44 (0) 1223 897555
Gilead Sciences Sweden AB Tel: + 46 (0) 8 5057 1849
The following information is intended for medical or healthcare professionals only:
Vistide vials should be inspected visually prior to use. If visible particles or discolouration are observed, the vial should not be used.
Adequate precautions including the use of appropriate safety equipment are recommended for the preparation, administration and disposal of Vistide. The preparation of Vistide diluted solution should be done in a laminar flow biological safety cabinet. Personnel preparing the solution should wear
surgical gloves, safety glasses and a closed front surgical-type gown with knit cuffs. If Vistide contacts the skin, wash membranes and flush thoroughly with water.
The appropriate dose of Vistide should be transferred from the vial to an infusion bag containing 100 ml 0.9% (normal) saline solution. The entire volume of the bag should be infused into the patient’s vein at a constant rate over a period of 1 hour using a standard infusion pump. The recommended dose, frequency of use, or rate of infusion must not be exceeded.
The chemical stability of Vistide mixed in saline solution has been demonstrated in glass bottles, in infusion bags composed of either polyvinyl chloride (PVC) composition or ethylene/propylene copolymer, and in PVC based vented IV administration sets. Other types of IV set tubing and infusion bags have not been studied.
Compatibility of Vistide with Ringer’s Solution, Lactated Ringer’s Solution or bacteriostatic infusion fluids has not been evaluated.
Medicinal product no longer authorised
Vistide is supplied in single-use vials. Partially used vials must be discarded.