Antiretroviral Agents: Nucleoside Reverse Transcriptase Inhibitors

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zidovudine

Detailed Prescribing Information

October 2005

Retrovir = zidovudine = AZT or ZDV Also a component of Combivir and Trizivir
Forms Available	100 mg caps & 300 mg tabs Syrup 10 mg/cc in bottles of 240 cc (300 mg ZDV + 3TC 150 mg = Combivir) (300 mg ZDV + 150 mg 3TC + 300 mg abacavir = one Trizivir tablet)
Dosing	300 mg twice a day
	Renal dosing: 100 mg every 6-8 hours
	Hepatic dosing: a dosing reduction may be necessary in mild to moderate hepatic insufficiency - follow hematologic parameters closely
Food dependence	Best taken on an empty stomach or will low-fat food (fatty food decreases absorption)
Adverse Effects	Actually relatively well tolerated in most patients Bone marrow depression with leukopenia and anemia (not thrombocytopenia) Macrocytic anemia (consider if zidovudine is essential rHuEPO) Leukopenia, granulocytopenia (consider GM-CSF or G-CSF if zidovudine is essential or important) Mild GI upset is common (usually mild), nausea (sometimes severe) Headache usually mild and improves with time. Some liver toxicity, especially with heavy alcohol use. Mitochondrial toxicity: zidovudine may contribute to fat redistribution / lipoatrophy; rare hepatic steatosis and lactic acidosis
Interactions	Zidovudine intensifies other marrow suppressive agents: Ganciclovir Sulfadiazine Sulfamethoxazole/trimethoprim (esp treatment dosing) Dapsone Antineoplastic chemotherapy Interferon
Suggested lab follow-up	Monitor CBC at baseline and monthly x 3, then periodically and PRN If the patient has pre-existing leukopenia or anemia, consider using another agent, follow labs closely, or use colony stimulating factors.
Warning	Avoid use with stavudine (in vitro and in vivo antagonism) Rare lactic acidosis especially in persons with underlying liver disease: nausea, malaise, anion gap acidosis, renal failure, hepatic steatosis
Complete prescribing information	Retrovir	http://www.gsk.com/products/retrovir_us.htm
	Combivir	http://www.gsk.com/products/prescriptionmedicines.shtml
	Trizivir	Prescribing Information

Links to Antiretroviral Sections (click on anything)

Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI)

AZT | ddC | ddI | d4T | 3TC | ABC | FTC | TDF | Combivir | Trizivir | Epzicom | Truvada

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTI)

efavirenz | nevirapine | delavirdine

Protease Inhibitors (PI) | Boosted Protease Inhibitors

Fusion Inhibitors

enfuvirtide

Quick Menu / Table of Contents
Introduction	Principles	Management	NRTI Key	NRTI Info
NNRTI Key	NNRTI Info	PI Key	PI Info	Fusion Inhibitors
Drug Summary	Investigational	Adherence	Lab Evaluation	Resistance Tests
PEP	Antiretroviral Tables	OI Prevention	Vaccinations	TB Therapy
Hepatitis Therapy	OI Diagnosis	OI Therapy	Bibliography	Links

Updated 10.25.2005

1. Renal dosing information from: Ian R. McNicholl & Rudolph A. Rodriguez, MD, Dosing of Antiretroviral Drugs in Renal Insufficiency and Hemodialysis, May 2004
http://hivinsite.ucsf.edu/InSite?page=md-rr-18