Select a medication above to begin.
Retrovir
zidovudine
Black Box Warnings .
Hematologic Toxicity
zidovudine-assoc. neutropenia and severe anemia, especially in pts w/ advanced HIV
Myopathy
symptomatic myopathy assoc. w/ prolonged zidovudine use
Lactic Acidosis/Severe Hepatomegaly with Steatosis
lactic acidosis and severe hepatomegaly w/ steatosis, incl. fatal cases, associated w/ nucleoside analog use alone or in combination; incr. risk if female, obese, or long-term nucleoside analog tx; suspend tx if clinical or laboratory findings suggest lactic acidosis or hepatotoxicity
Adult Dosing .
Dosage forms: CAP: 100 mg; SOL: 50 mg per 5 mL; INJ: various
HIV infection
- [300 mg PO bid]
- Alt: 200 mg PO tid; 1 mg/kg/dose IV q4h x5-6 doses/day
HIV infection prevention, perinatal
- [pregnancy >14 wk gestation]
- Dose: 100 mg PO 5x/day until labor onset; Alt: 200 mg PO tid or 300 mg PO bid until labor onset
- [labor and delivery]
- Dose: 2 mg/kg/dose IV x1, then 1 mg/kg/h IV for at least 2h; Start: at labor onset or >3h before scheduled cesarean delivery; Alt: 600 mg PO x1, then 400 mg PO q3h; Info: for pts w/ HIV-1 RNA >1,000 or unknown; IV preferred to PO
HIV post-exposure prophylaxis (off-label)
- [300 mg PO bid]
- Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Occupational and HIV Post-Exposure Prophylaxis, Nonoccupational tables
renal dosing
- [PO route]
- CrCl <15: 100 mg PO q6-8h
- HD: 100 mg PO q8h, on dialysis days admin. after dialysis; no supplement; PD: 100 mg PO q8h; no supplement
- [IV route, if usual dose 1 mg/kg/dose q4h]
- CrCl <15: 1 mg/kg/dose IV q6-8h
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: consider decr. usual dose
Peds Dosing .
- Dosage forms: CAP: 100 mg; SOL: 50 mg per 5 mL; INJ: various
HIV infection
- [<30 wk gestation, <4 wk old (off-label)]
- Dose: 4 mg/kg/day PO divided bid; Alt: 3 mg/kg/day IV divided q12h
- [<30 wk gestation, 4-8 wk old (off-label)]
- Dose: 6 mg/kg/day PO divided bid; Alt: 4.5 mg/kg/day IV divided q12h
- [<30 wk gestation, >8 wk old (off-label)]
- Dose: 24 mg/kg/day PO divided bid; Alt: 18 mg/kg/day IV divided q12h
- [30-34 wk gestation, <2 wk old (off-label)]
- Dose: 4 mg/kg/day PO divided bid; Alt: 3 mg/kg/day IV divided q12h
- [30-34 wk gestation, 2-6 wk old (off-label)]
- Dose: 6 mg/kg/day PO divided bid; Alt: 4.5 mg/kg/day IV divided q12h
- [30-34 wk gestation, >6 wk old (off-label)]
- Dose: 24 mg/kg/day PO divided bid; Alt: 18 mg/kg/day IV divided q12h
- [>35 wk gestation, <4 wk old (off-label)]
- Dose: 8 mg/kg/day PO divided bid; Alt: 6 mg/kg/day IV divided q12h
- [>35 wk gestation, 4 wk old and older, 4-8 kg]
- Dose: 24 mg/kg/day PO divided bid-tid; Max: 600 mg/day; Alt: 480 mg/m^2/day PO divided bid-tid; 18 mg/kg/day IV divided q8-12h
- [>35 wk gestation, 4 wk old and older, 9-29 kg]
- Dose: 18 mg/kg/day PO divided bid-tid; Max: 600 mg/day; Alt: 480 mg/m^2/day PO divided bid-tid; 13.5 mg/kg/day IV divided q8-12h
- [>35 wk gestation, 4 wk old and older, >30 kg]
- Dose: 600 mg/day PO divided bid-tid; Max: 600 mg/day; Alt: 480 mg/m^2/day PO divided bid-tid; 450 mg/day IV divided q8-12h
HIV infection prevention, neonatal
- [<30 wk gestation, low-risk pts]
- Dose: 4 mg/kg/day PO divided q12h x4wk, then 6 mg/kg/day PO divided q12h x2wk; Start: w/in 12h after birth; Alt: 3 mg/kg/day IV divided q12h x4wk, then 4.5 mg/kg/day IV divided q12h x2wk; Info: incl. breastfeeding pts; total duration 4-6wk; refer to DHHS guidelines
- [<30 wk gestation, high-risk pts]
- Dose: 4 mg/kg/day PO divided q12h x4wk, then 6 mg/kg/day PO divided q12h x2wk; Start: w/in 12h after birth; Alt: 3 mg/kg/day IV divided q12h x4wk, then 4.5 mg/kg/day IV divided q12h x2wk; Info: give w/ lamivudine and either nevirapine or raltegravir; may give as 2-drug regimen w/ nevirapine; refer to DHHS guidelines
- [30-34 wk gestation, low-risk pts]
- Dose: 4 mg/kg/day PO divided q12h x2wk, then 6 mg/kg/day PO divided q12h x2-4wk; Start: w/in 12h after birth; Alt: 3 mg/kg/day IV divided q12h x2wk, then 4.5 mg/kg/day IV divided q12h x2-4wk; Info: incl. breastfeeding pts; total duration 4-6wk; refer to DHHS guidelines
- [30-34 wk gestation, high-risk pts]
- Dose: 4 mg/kg/day PO divided q12h x2wk, then 6 mg/kg/day PO divided q12h x4wk; Start: w/in 12h after birth; Alt: 3 mg/kg/day IV divided q12h x2wk, then 4.5 mg/kg/day IV divided q12h x4wk; Info: give w/ lamivudine and either nevirapine or raltegravir; may give as 2-drug regimen w/ nevirapine; refer to DHHS guidelines
- [35-36 wk gestation, low-risk pts]
- Dose: 8 mg/kg/day PO divided q12h x4-6wk; Start: w/in 12h after birth; Alt: 6 mg/kg/day IV divided q12h x4-6wk; Info: incl. breastfeeding pts; total duration 4-6wk; refer to DHHS guidelines
- [35-36 wk gestation, high-risk pts]
- Dose: 8 mg/kg/day PO divided q12h x6wk; Start: w/in 12h after birth; Alt: 6 mg/kg/day IV divided q12h x6wk; Info: give w/ lamivudine and either nevirapine or raltegravir; may give as 2-drug regimen w/ nevirapine; refer to DHHS guidelines
- [>37 wk gestation, low-risk pts]
- Dose: 8 mg/kg/day PO divided q12h x4-6wk; Start: w/in 12h after birth; Alt: 8 mg/kg/day PO divided q12h x2wk; 6 mg/kg/day IV divided q12h x4-6wk; 6 mg/kg/day IV divided q12h x2wk; Info: incl. breastfeeding pts; refer to DHHS guidelines
- [>37 wk gestation, high-risk pts]
- Dose: 8 mg/kg/day PO divided q12h x6wk; Start: w/in 12h after birth; Alt: 6 mg/kg/day IV divided q12h x6wk; Info: give w/ lamivudine and either nevirapine or raltegravir; may give as 2-drug regimen w/ nevirapine; refer to DHHS guidelines
HIV post-exposure prophylaxis, nonoccupational (off-label)
- [<30 wk gestation, 14-28 days old]
- Dose: 4 mg/kg/day PO divided bid; Alt: 3 mg/kg/day IV divided q12h; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [<30 wk gestation, 29 days old and older]
- Dose: 8 mg/kg/day PO divided bid; Alt: 6 mg/kg/day IV divided q12h; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [30-35 wk gestation, <2 wk old]
- Dose: 4 mg/kg/day PO divided bid; Alt: 3 mg/kg/day IV divided q12h; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [30-35 wk gestation, 15 days old and older]
- Dose: 8 mg/kg/day PO divided bid; Alt: 6 mg/kg/day IV divided q12h; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [>35 wk gestation, <41 days old]
- Dose: 8 mg/kg/day PO divided bid; Alt: 6 mg/kg/day IV divided q12h; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [>35 wk gestation, 4 wk old and older, 4-8 kg]
- Dose: 24 mg/kg/day PO divided bid; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [>35 wk gestation, 4 wk old and older, 9-29 kg]
- Dose: 18 mg/kg/day PO divided bid; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
- [>35 wk gestation, 4 wk old and older, >30 kg]
- Dose: 300 mg PO bid; Info: part of multi-drug regimen; refer to HIV Post-Exposure Prophylaxis, Nonoccupational table
renal dosing
- [0-14 days old, <2 kg]
- renal impairment: not defined
- HD/PD: not defined
- [>14 days old, >2 kg]
- CrCl <10: give 50% usual divided dose q8h
- HD: give 50% usual divided dose q8h, on dialysis days admin. after dialysis; no supplement; PD: give 50% usual divided dose q8h; no supplement
hepatic dosing
- [see below]
- hepatic impairment: consider decr. usual dose