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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIVIRALS FOR SYSTEMIC USE › DIRECT ACTING ANTIVIRALS › Nucleoside and nucleotide reverse transcriptase inhibitors
zidovudine
J05AF01
Forms & Strengths
- Capsule: 100 mg
- Syrup: 50 mg/5 mL
- Solution for intravenous infusion: 10 mg/mL
Adult Dosing
- HIV infection (oral): 300 mg twice daily or 200 mg three times daily
- Prevention of maternal-fetal HIV transmission: 100 mg 5 times daily until onset of labor
- Intravenous dosing (alternative): 1 mg/kg every 4 hours
Pediatric Dosing
- Neonates (birth to 6 weeks): Oral 2 mg/kg every 6 hours or IV 1.5 mg/kg every 6 hours
- Children (6 weeks to 12 years): Oral 90 to 180 mg/m2 every 12 hours (maximum 300 mg twice daily)
Indications
- Treatment of HIV-1 infection in combination with other antiretroviral agents
- Prevention of maternal-fetal HIV transmission
Mechanism of Action
- Thymidine analogue and nucleoside reverse transcriptase inhibitor (NRTI)
- Competes with thymidine triphosphate for viral RNA-dependent DNA polymerase, causing chain termination and inhibition of viral replication
Contraindications
- Clinically significant hypersensitivity to zidovudine
- Patients with abnormally low neutrophil counts (< 0.75 x 10^9/L) or hemoglobin levels (< 7.5 g/dL)
Adverse Reactions
- Bone marrow suppression (anemia, neutropenia)
- Lactic acidosis and severe hepatomegaly with steatosis
- Myopathy
- Nausea, headache, insomnia, asthenia
- Hyperpigmentation of nails
Drug Interactions
- Myelosuppressive drugs (e.g., ganciclovir, ribavirin, interferon alfa) increase risk of hematotoxicity
- Stavudine antagonizes the antiviral activity of zidovudine; coadministration should be avoided
- Probenecid and valproic acid may increase zidovudine exposure via inhibition of glucuronidation
Curated Content: Needs Vetting Before Put to Clinical Use