CIDOFOVIR (VISTIDE) INFUSION FOR CMV		version 2/27/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Every 14 days	S	 treatments	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	Basic metabolic panel	Every 14 days	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	CBC with platelet and differential	Every 14 days	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Cytomegalovirus by PCR	Every 14 days	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Cytomegalovirus antigen	Every 14 days	S	Until discont'd	
		STAT, Normal, Clinic Collect		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every 14 days	S	Until discont'd	
		No details available for preview		
	☐	sodium chloride 0.9% flush 10 mL	Every 14 days	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	sodium chloride 0.9% infusion 250 mL	Every 14 days	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Nursing communication	Every 14 days	S	Until discont'd	
		Please verify patient received 2 gram dose of oral probenecid approximately 3 hours prior to initiation of cidofovir infusion.		
	☐	Nursing communication	Every 14 days	S	Until discont'd	
		Please remind patient to take 1 gram (2 tablets) both 2 hours and 8 hours after end of infusion.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	cidofovir (VISITIDE) 5 mg/kg in sodium chloride 0.9% 1,000 mL IVPB	Every 14 days	S	Until discont'd	
		5 mg/kg, intravenous, Administer over: 3 Hours, once, Starting at treatment start time		

Discharge Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Discontinue IV	Every 14 days	S	Until discont'd	
		Normal