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Zidovudine
Aka: Zidovudine, Retrovir, ZDV, AZT
- See Also
- Anti-Retroviral Therapy
- Nucleoside Reverse Transcriptase Inhibitor
- Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Thymidine analogue
- Interferes with viral reverse transcriptase
- Interferes with elongation of the viral DNA chain
- Pharmacokinetics
- Well absorbed from the Gastrointestinal Tract
- Glucuronidase added in the liver
- Excreted by the Kidney
- Crosses the blood-brain barrier and the placenta
- Efficacy
- Delays the progression to AIDS and late HIV
- Increases CD4 Counts
- Suppresses viral replication in mild HIV (CD4 200-500)
- Dosing
- Zidovudine 200 mg PO tid ($279/month) OR
- Zidovudine 300 mg PO bid
- Adverse effects: General
- See nRTI for adverse effects attributed to the class
- Short term
- Headache
- Myalgia
- Malaise
- Fatigue
- Insomnia
- Nausea or Vomiting
- Bloating
- Dyspepsia
- Long term
- Nail and Oral Mucosa Hyperpigmentation
- Myopathy
- Adverse Effects: Major toxicities
- Effects
- Anemia (Macrocytosis) (7% late, 1.8% early)
- Leukopenia (Neutropenia) (37% late, 4% early)
- Hepatitis
- Management of toxicity
- Interrupt treatment
- Results in reversal of Anemia and Neutropenia
- Specific Therapy
- Anemia: Give Erythropoietin
- Neutropenia: Give growth factors
- Persistent Anemia or Neutropenia
- Change therapy
- Monitoring
- Advanced disease: Complete Blood Count each month
- Early disease: Complete Blood Count every 2-3 months
- Resistance
- Develops 6 months into therapy
- References
- (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
- (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]
- Reust (2011) Am Fam Physician 83(12): 1443-51 [PubMed]