Zidovudine

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Azidothymidine; AZT

Definition
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Half-life
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1 h

Pharmacodynamics (Effect)
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Nucleoside analogue. Competitive inhibition of HIV reverse transcriptase in HIV infection.

Indication
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Combination therapy of HIV infection.

Pregnancy/nursing period
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Do not breastfeed while taking this medicine!

Dosage and method of use
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  • Peroral application (cps/filmbl./sg.): Adults: 500-600 mg/day divided into 2-3 EDs. Children > 3 months - 12 years 360-480 mg/m2 KO/day divided into 3-4 ED.
  • I.v. application: adults (70 kg): 1 or 2 mg/kg bw every 4 hours, children: 80-160 mg/m2 KO every 6 hours i.v.
  • Infants > 3 months: 12 mg/kg bw/day
  • infants < 3 months: 8 mg/kg bw/day

Remember! Men should not conceive children during AZT treatment and up to 6 months (e.g. as part of post-exposure prophylaxis) afterwards!

Undesirable effects
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  • Cutaneous ADRs: erythroderma, maculopapular exanthema, urticaria, nail pigmentation.
  • Also: anemia, neutropenia, leukopenia, gastrointestinal problems, fever, headache, reaction limitation, paresthesias, proximal myopathies in long-term use.

    Notice! Increase of side effects with simultaneous administration of Cotrimoxazole and Pyrimethamine

    . Simultaneous administration of ganciclovir almost always results in myelosuppression, which can be corrected by administration of G-CSF!

Interactions
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See Table 1.

Contraindication
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Cytostatic treatment of lymphoma or Kaposi's sarcoma, severe liver and kidney dysfunction.

Preparations
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Retrovir

Note(s)
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The effective level in the liquor is about 50% of the plasma level.

Tables
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Main interactions of zidovudine

Acetylsalicylic acid

Zidovudine toxicity ↑

Aciclovir

rarely seizures ↑

amphotericin B

Haematotoxicity ↑

Anti-inflammatories, non-steroidal

Zidovudine toxicity ↑

Atovaquon

Zidovudine plasma levels ↑ by 35%

Barbiturates

Zidovudine toxicity ↑

Cotrimoxazole

Myelosuppression ↑

Dapson

Myelosuppression ↑

Doxorubicin

Myelosuppression ↑

Etoposide

Myelosuppression ↑

Fluconazole

Zidovudine plasma mirror ↑

Flucytosine

Haematotoxicity ↑

Foscarnet

Anemia

Ganciclovir

Haematotoxicity ↑, avoid combination

Levomethadone

Zidovudine plasma mirror ↑

Pentamidine i.v.

rarely hematotoxicity ↑

Ribavirin

Ribavirin effect ↓

Rifabutin

Zidovudine plasma mirror ↓

Sulfonamides

Haematotoxicity ↑

Vinblastine

Haematotoxicity ↑

Vincrist

Haematotoxicity ↑

Authors

Last updated on: 29.10.2020