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Zidovudine
Zidovudine, also known by its brand name Retrovir, is an antiretroviral medication used to treat HIV infection. It belongs to a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). Zidovudine works by inhibiting the reverse transcriptase enzyme, which is necessary for the replication of HIV, thereby helping to reduce the viral load in the body and improve immune function. It is often used as part of combination antiretroviral therapy (ART) to effectively manage HIV infection and prevent the progression to AIDS.
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Frequently Asked Questions
How long does it take for zidovudine to start working?
Zidovudine starts to work soon after the first dose, but the full effect on lowering HIV viral load and improving immune function can take several weeks to months, depending on the combination therapy and individual response.
Can zidovudine cure HIV?
No, zidovudine does not cure HIV, but it helps manage the infection by lowering the amount of virus in the body and improving immune function. Long-term therapy is necessary to maintain control of the virus.
What should I do if I miss a dose of zidovudine?
If you miss a dose of zidovudine, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose to make up for a missed dose.
Can zidovudine be taken during pregnancy?
Yes, zidovudine is commonly used during pregnancy to prevent mother-to-child transmission of HIV. Pregnant women should take zidovudine under the supervision of a healthcare provider.
Is zidovudine still used in HIV treatment?
Yes, zidovudine is still used, but it has been replaced by newer NRTIs in many treatment regimens due to its side effects. However, it remains a key medication for certain patients and for preventing mother-to-child transmission of HIV.
Comprehensive Drug Guide
How Does Zidovudine Work?
Zidovudine works by inhibiting reverse transcriptase, an enzyme that HIV uses to replicate its genetic material (RNA) into DNA. By blocking this enzyme, zidovudine prevents the virus from multiplying and integrating into the host’s cells, which helps reduce the viral load in the blood and slows the progression of the disease.
Common Dosages
- Capsules: 100 mg
- Tablets: 300 mg
- Oral solution: 50 mg/5 mL
The typical dosages are:
- Adults: 300 mg twice daily in combination with other antiretroviral drugs.
- Children: The dosage is typically based on body weight, and your healthcare provider will determine the appropriate dosing.
Typical Dosing
- For HIV infection: The recommended dose in adults is 300 mg twice daily in combination with other antiretroviral agents. It can be taken with or without food.
- For maternal-fetal HIV transmission prevention: Zidovudine is given to pregnant women starting at 14 weeks of gestation, continuing through labor, and is also administered to the newborn for the first 6 weeks of life.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in combination with other antiretroviral agents.
- Prevention of maternal-fetal transmission of HIV during pregnancy and delivery when used as part of a complete regimen.
Who Shouldn't Take Zidovudine?
- Hypersensitivity to zidovudine or any of its components.
- Severe bone marrow suppression, including low neutrophil or platelet counts.
- Severe liver disease, as zidovudine may exacerbate liver dysfunction.
Advice From The Pharmacist
- Zidovudine can be taken with or without food, but it’s important to follow your doctor’s instructions on how and when to take it.
- Stay hydrated and avoid excessive alcohol consumption while taking zidovudine, as this can worsen certain side effects, particularly those affecting the liver.
- Regular blood tests are required to monitor for bone marrow suppression, anemia, and liver function during treatment.
- It is important to take zidovudine exactly as prescribed and not to skip doses. Missing doses may lead to drug resistance and reduced effectiveness of treatment.
- Zidovudine may cause muscle pain or weakness with long-term use. Report any persistent muscle aches to your healthcare provider.
Side Effects of Zidovudine
Common Side Effects
- Headache
- Nausea and vomiting
- Fatigue
- Anemia (low red blood cell count)
- Neutropenia (low white blood cell count)
- Muscle pain or weakness
Uncommon/Severe Side Effects
- Lactic acidosis (a buildup of lactic acid in the blood), which can be life-threatening. Symptoms include weakness, muscle pain, difficulty breathing, and stomach pain.
- Severe liver toxicity, including liver enlargement (hepatomegaly) and fatty liver disease (hepatic steatosis).
- Myopathy (muscle damage) with long-term use.
Risks and Warnings of Zidovudine
- Bone Marrow Suppression: Zidovudine can cause anemia and neutropenia, especially in people with advanced HIV. Blood tests are regularly needed to monitor for these conditions, and dose adjustments may be necessary if bone marrow suppression occurs.
- Lactic Acidosis and Hepatic Steatosis: Zidovudine may cause lactic acidosis and severe liver damage, particularly in women, obese individuals, and patients who have taken antiretroviral therapy for a long time. Symptoms of lactic acidosis include difficulty breathing, stomach pain, and fatigue.
- Myopathy: Long-term use of zidovudine has been associated with muscle damage. Patients should report any persistent muscle weakness to their healthcare provider.
- Pregnancy: Zidovudine is often used to prevent the transmission of HIV from mother to child. It is generally considered safe during pregnancy but should only be used under medical supervision.
Interactions with Zidovudine
Common Drug Interactions
- Ganciclovir and ribavirin: These antiviral drugs can increase the risk of bone marrow suppression when used with zidovudine.
- Doxorubicin: Combining this chemotherapy drug with zidovudine may increase the risk of toxic side effects.
- Phenytoin: Zidovudine may either increase or decrease the levels of phenytoin, a drug used to control seizures, so close monitoring is needed.
- Methadone: Methadone may increase the levels of zidovudine in the blood, which could raise the risk of side effects.
Alternatives to Zidovudine
- Tenofovir disoproxil fumarate (TDF): Another NRTI used in the treatment of HIV as part of combination therapy.
- Lamivudine (Epivir): An NRTI often used in combination with other antiretrovirals, including zidovudine, for the treatment of HIV.
- Abacavir (Ziagen): Another NRTI used in combination with other HIV medications.
- Emtricitabine (Emtriva): An NRTI used as part of combination therapy for HIV treatment.
