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Zidovudine

Zidovudine

Description

A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIV-induced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leucopenia.

Why is this medication prescribed?

Zidovudine is used along with other medications to treat human immunodeficiency virus (HIV) infection. Zidovudine is given to HIV-positive pregnant women to reduce the chance of passing the infection to the baby. Zidovudine is in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). It works by decreasing the amount of HIV in the blood. Although zidovudine does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other life-style changes may decrease the risk of transmitting (spreading) the HIV virus to other people.

How should this medicine be used?

Zidovudine comes as a capsule, tablet, and syrup to take by mouth. It is usually taken twice a day by adults and two to three times a day by infants and children. Infants 6 weeks of age and younger may take zidovudine every 6 hours. When zidovudine is taken by pregnant women, it may be taken 5 times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take zidovudine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Zidovudine Dosage

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Zidovudine can be taken with or without food.

If a child is using this medicine, tell your doctor if the child has any changes in weight. Zidovudine doses are based on weight in children, and any changes may affect your child's dose.

Side Effects

Headache, nausea, vomiting, trouble sleeping, or loss of appetite may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including: unexplained weight loss, severe tiredness, muscle aches/weakness that doesn't go away, headaches that are severe or don't go away, joint pain, numbness/tingling of the hands/feet/arms/legs, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre syndrome (such as trouble breathing/swallowing/moving your eyes, drooping face, paralysis, trouble speaking).

Pregnancy

Zidovudine (AZT, Retrovir) is the only anti-HIV drug that is fully approved for use during pregnancy.

Current guidelines from the British HIV Association recommend that pregnant women take the anti-HIV drugs they require regardless of their pregnancy, with the exception of efavirenz (Sustiva).1 However, women who would otherwise not require HIV therapy due to high CD4 cell counts and low viral loads, can reduce the chance of mother-to-baby transmission by taking zidovudine during pregnancy and labour.2 3 4 Current guidelines recommend zidovudine monotherapy in women with HIV viral loads below 10,000 copies/ml and wild-type virus who do not require or want to take antiretroviral therapy during pregnancy and are willing to deliver by caesarean section prior to the onset of labour.

Zidovudine monotherapy should begin in the third trimester of pregnancy, at a dose of 100mg five times per day. During labour, zidovudine should be administered intravenously at 2mg/kg over one hour, followed by 1mg/kg per hour until the umbilical cord is clamped. The baby should then be given 2mg/kg zidovudine by mouth every six hours starting within twelve hours of birth, until six weeks of age. For babies that cannot be given the oral solution, zidovudine should be given intravenously at 1.5mg/kg, infused over 30 minutes, every six hours.5 6

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