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 7, 2018; Last Reviewed: December 7, 2018

Excerpt from Table 10a

Note: When using FDCs, refer to other sections in Appendix B and Table 10 for information about the dosing and safety of individual drug components of the FDC during pregnancy.

Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendations Use in Pregnancy
Zidovudine
(ZDV, AZT)
Retrovir

(ZDV/3TC)
Combivir

(ZDV/ABC/3TC)
Trizivir

Note: Generics available for all formulations.
ZDV (Retrovir)
Capsule:
  • 100 mg
Tablet:
  • 300 mg
Oral Solution:
  • 10 mg/mL
Intravenous Solution:
  • 10 mg/mL

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

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

Standard Adult Dose
ZDV (Retrovir):
  • ZDV 300 mg BID or ZDV 200 mg TID, without regard to food
Active Labor:
  • ZDV 2 mg/kg IV loading dose, followed by ZDV 1 mg/kg/hour continuous infusion from beginning of active labor until delivery

Combivir
:
  • 1 tablet twice daily, without regard to food
Trizivir:
  • 1 tablet twice daily, without regard to food

Dosing in Pregnancy:
  • No change in dose is indicated.
PK in Pregnancy:
  • PK is not significantly altered in pregnancy.
  • For guidance about 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 dosages may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
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 to Acronyms: 3TC = lamivudine; ABC = abacavir; ARV = antiretroviral BID = twice daily; FDC = fixed-dose combination; IV = intravenous; PK = pharmacokinetic; TID = three times a day; ZDV = zidovudine

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