Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Nucleoside and Nucleotide Analogue Reverse Transcriptase Inhibitors

Zidovudine (Retrovir, AZT, ZDV)

Last Updated: December 24, 2019; Last Reviewed: December 24, 2019

Excerpt from Table 8

Note: When using FDC tablets, refer to other sections in Appendix B and Table 8 for information about the dosing and safety of the individual drug components of the FDC tablet during pregnancy.

Excerpt from Table 8
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendationsa Use in Pregnancy
Zidovudine
(ZDV)
Retrovir

(ZDV/3TC)
Combivir

(ZDV/ABC/3TC)
Trizivir

Note: Generic products are available for all formulations.
ZDV (Retrovir)
Capsule:
  • 100 mg
Tablet:
  • 300 mg
Oral Solution:
  • 10 mg/mL
IV Solution:
  • 10 mg/mL

ZDV/3TC (Combivir):
  • ZDV 300 mg/3TC 150 mg tablet

ZDV/ABC/3TC (Trizivir):
  • ZDV 300 mg/ABC 300 mg/3TC 150 mg tablet

Standard Adult Dose
ZDV (Retrovir):
  • ZDV 300 mg twice daily or ZDV 200 mg three times a day without regard to food
  • Patients in active labor should receive ZDV 2 mg/kg IV as a loading dose, followed by ZDV 1 mg/kg/hour continuous infusion from beginning of active labor until delivery.

ZDV/3TC (Combivir):
  • One tablet twice daily without regard to food
ZDV/ABC/3TC (Trizivir):
  • One tablet twice daily without regard to food

Pregnancy
PKs in Pregnancy:
  • PKs not significantly altered in pregnancy.
Dosing in Pregnancy:
  • No change in dose indicated.
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., ABC, 3TC)
High placental transfer to fetus.b

No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects).
a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Antiretroviral Guidelines, Appendix B, Table 10).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3

Key: 3TC = lamivudine; ABC = abacavir; ARV = antiretroviral; FDC = fixed-dose combination; IV = intravenous; PK = pharmacokinetic; ZDV = zidovudine

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