Caso presentado por: Ana Capela, Carla Sampaio, Manuela Vieira, Renata Barbosa, Susana Fraga, Teresa Soares
Descripción del caso clínico
Tratamientos posibles y problemas relacionados con la medicación
The case was refractory to all on-label available therapies and has been prescribed topical cidofovir.
Cidofovir is a broad-spectrum antiviral agent with activity against several dna viruses. in Portugal, it has to be imported but it has European Medicines Agency’s approval to treat cytomegalovirus retinitis in specific patient conditions.
Numerous studies substantiate the prescription, which led to its approval by the referred hospital boards. cidofovir 3% cream was compoundedfrom injectable Cidofovir (vistidine®) and incorporated into commercially available fat cream (lipolium®). Due to cidofovir’s mutagenic properties and its associated risk by exposure, this preparation was performed with propper protection equipment and using luer-lock system (syringes and connectors).
Intervención farmacéutica de mejora
Offlabel therapeutic options should be reserved only for specific cases. However, as long as there are no topical options available, compounding pharmacist can be essential, providing an effective and safe formulation. operator’s safety should not be neglected, and the preparation must be carried out with appropriate precautions/protetion equipment.
Pharmaceutical intervention: 1. Bibliographic research. 2. Prescription submission for approval of ethics committee for health and clinical board of the hospital.3. Elaboration of master formula sheet performed with propper protection equipment and parameterization of labeling information. 4. Topical cidofovir preparation. 5. Patient information.
Resultados de la intervención
After three months of treatment,topical cidofovir proved to be effective, as the patient presentedwith reduced number of lesions and less evidence of pruritus. he referred no symptoms of local irritation (the most reported adverse reaction).
It should be noted that the success of this treatment required the commitment of a multidisciplinary team, with consequent improvement of patient’s life quality.
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