Nucleoside and Nucleotide Analogue Reverse Transcriptase Inhibitors (NRTIs)
Last Updated: May 22, 2018; Last Reviewed: May 22, 2018
Zidovudine (ZDV, AZT, Retrovir)
|Zidovudine (ZDV, AZT, Retrovir)
For additional information see Drugs@FDA: https://www.accessdata.fda.gov/scripts/cder/daf/
|Capsules: 100 mg
Tablets: 300 mg
Syrup: 10 mg/mL
Concentrate for Injection or Intravenous Infusion: 10 mg/mL
Zidovudine capsules, tablets, syrup, and injection are approved by the Food and Drug Administration for manufacture and distribution in the United States.
Fixed-Dose Combination Tablets:
- [Combivir and Generic] Lamivudine 150 mg plus zidovudine 300 mg (scored)
- [Trizivir] Abacavir 300 mg plus lamivudine 150 mg plus zidovudine 300 mg
||Selected Adverse Events
|Note: See Antiretroviral Management of Newborns with Perinatal HIV Exposure or Perinatal HIV and Table 12 for information about using zidovudine to prevent perinatal transmission.
Recommended Neonatal Dose for Treatment of HIV by Gestational Age (Weeks) at Birtha
Infant (Aged ≥35 Weeks Post-Conception and ≥4 Weeks Post-Delivery, Weighing ≥4 kg) and Child Dose
Zidovudine Weight-Based Dosing
Alternative Body Surface Area Dosing
Adolescent (Aged ≥18 Years) and Adult Dose:
[Combivir and Generic] Lamivudine plus Zidovudine
- Oral: 180–240 mg/m2 body surface area every 12 hours
Adolescent (Weighing ≥30 kg) and Adult Dose:
[Trizivir] Abacavir plus Lamivudine plus Zidovudine
Adolescent (Weighing ≥40 kg) and Adult Dose:
- Bone marrow suppression: macrocytosis with or without anemia, neutropenia
- Nausea, vomiting, headache, insomnia, asthenia
- Lactic acidosis/severe hepatomegaly with hepatic steatosis
- Lipodystrophy and lipoatrophy
- Myopathy (associated with prolonged use of zidovudine) and myositis
- Give zidovudine without regard to food.
- If substantial granulocytopenia or anemia develops in patients receiving zidovudine, it may be necessary to discontinue therapy until bone marrow recovery is observed. In this setting, some patients may require erythropoietin or filgrastim injections or transfusions of red blood cells.
- For infants unable to tolerate oral agents, the intravenous (IV) dose should be 75% of the oral dose, but the dosing interval should remain the same.
- When using fixed-dose combination (FDC) tablets that contain zidovudine, see other sections of the Drug Appendix for special instructions and additional information about the individual components of the FDC.
Zidovudine Dosing in Patients with Renal Impairment:
- Metabolized primarily in the liver to zidovudine glucuronide, which is renally excreted.
- Zidovudine is phosphorylated intracellularly to active zidovudine-triphosphate.
Zidovudine Dosing in Patients with Hepatic Impairment:
- Dose adjustment is required in renal insufficiency.
- Dose may need to be reduced in patients with hepatic impairment.
- Do not use FDC products (e.g., Combivir, Trizivir) in patients with creatinine clearance <50 mL/min or in patients who are on dialysis or who have impaired hepatic function.