Zidovudine should be given for four weeks after delivery. Zidovudine is recommended as an alternative agent for use in first-line treatment of children aged 2 weeks to 3 years of age. It may be used as part of the NRTI backbone in second-line treatment if resistance to lamivudine or emtricitabine is detected.
The use of zidovudine during pregnancy is no longer recommended except in women not on treatment who have detectable viral load at the time of delivery. In these circumstances, women should begin oral treatment with zidovudine and lamivudine immediately and receive intravenous zidovudine during labour and delivery.
Fischl MA et al. New England Journal of Medicine, , JAMA, , A randomized controlled trial of a reduced daily dose of zidovudine in patients with the acquired immunodeficiency syndrome. Volberding PA et al. Zidovudine in asymptomatic HIV infection: a controlled trial in persons with fewer than CD4-positive cells per cubic millimetre.
A comparison of immediate with deferred zidovudine therapy for asymptomatic HIV-infected adults with CD4 cell counts of or more per cubic millimeter. Lederking WR et al. Evaluation of the quality of life associated with zidovudine treatment in asymptomatic human immunodeficiency virus infection. The Lancet, , Cooper DA et al. Mulder JW et al. Zidovudine twice daily in asymptomatic subjects with HIV infection and a high risk of progression to AIDS: a randomized, double-blind placebo-controlled study.
AIDS, 8: , Hamilton JD et al. A controlled trial of early versus late treatment with zidovudine in symptomatic human immunodeficiency virus infection. Simberkoff MS et al. Long-term follow-up of symptomatic HIV-infected patients originally randomized to early versus later zidovudine treatment; report of a Veterans Affairs Cooperative Study. Journal of Acquired Immune Deficiency Syndromes, , Merigan T et al. Placebo-controlled trial to evaluate zidovudine in treatment of human immunodeficiency virus infection in asymptomatic patients with haemophilia.
Blood, , Gardner LI et al. Military Consortium for Applied Retroviral Research. Zidovudine, didanosine, and zalcitabine in the treatment of HIV infection: meta-analyses of the randomised evidence.
Cressey TR et al. Intensive pharmacokinetics of zidovudine mg twice daily in HIV-1 infected patients weighing less than 60kg on highly active antiretroviral therapy. Antiviral Therapy, 8: S, Arnaudo E et al. Freiman JP et al. Two related conditions, lactic acidosis a buildup of lactic acid in the blood and hepatic steatosis excess fat in the liver , have occurred in some people who have used nucleoside analogues.
These conditions can be serious or fatal. They have mostly been seen in women and people who are overweight or who have been on nucleosides a long time, and can cause the following symptoms:. Lactic acidosis is rare less than one case per year for every thousand patients , and has mostly been seen with nucleoside analogues other than AZT.
If you do develop any of these symptoms, it does not necessarily mean you have lactic acidosis, but you should still let your doctor know right away. Common side effects that have been reported by some AZT users include headaches, nausea, vomiting, insomnia, tiredness, muscle pain, and loss of appetite.
Many people find that side effects caused by anti-HIV drugs improve or go away after the first several weeks of treatment. AZT may also cause myopathy, a weakness or loss of muscle mass, especially with long-term use. Lipodystrophy syndrome is the name given to a range of symptoms that can develop over time when people use ART. Some features of the lipodystrophy syndrome include:.
The precise causes of the HIV lipodystrophy syndrome are not clear and are difficult to understand because in some people with HIV there may be one or more aspects of the syndrome taking place. For instance, some people may experience fat wasting, others fat gain, and others may experience both fat gain and wasting.
What is becoming increasingly clear is that unfavourable changes in the lab readings of glucose, cholesterol, and triglycerides over a period of several years increase the risk of diabetes and cardiovascular disease. So far, however, the many benefits of ART are much greater than the increased risk of cardiovascular disease or other side effects. Maintaining a normal weight, eating a healthy diet, exercising regularly and quitting smoking are all important in helping you to reduce your risk of diabetes, heart disease, and other complications.
Regular visits to your doctor for checkups and blood tests are a vital part of staying healthy. If necessary, your doctor can prescribe lipid-lowering therapy. Researchers are studying the lipodystrophy syndrome to try to discover ways of helping people with HIV avoid or reduce this problem.
The drugs AZT and d4T are nukes that belong to a group of drugs called thymidine analogues. Thymidine analogues, particularly d4T and to a lesser extent AZT, have been associated with loss of the fatty layer just under the skin—lipoatrophy. Always consult your doctor and pharmacist about taking any other prescription or non-prescription medication, including herbs, supplements and street drugs. Some drugs can interact with AZT, increasing or decreasing its levels in your body.
Increased drug levels can cause you to experience side effects or make pre-existing side effects worse. On the other hand, if drug levels become too low, HIV can develop resistance and your future treatment options may be reduced. It may also be necessary to avoid drugs that do not affect AZT drug levels, but cause similar side effects.
If you must take a drug that has the potential to interact with your existing medications, your doctor can do the following:. The following drugs interact or have the potential to interact with AZT. These lists are not exhaustive. AZT should never be combined with d4T Zerit, stavudine , as these drugs interfere with each other.
For some people, but not all, methadone increases the blood level of AZT. Aspirin, codeine, morphine and a number of other drugs can also affect the metabolism of AZT, so use of these drugs should be discussed with your doctor.
The antibiotic clarithromycin can reduce the absorption of AZT. This can be avoided by taking the two medications at least two hours apart. Over time, as new copies of HIV are made in the body, the virus changes its structure.
These changes are called mutations and can cause HIV to resist the effects of anti-HIV drugs, which means those drugs will no longer work for you.
To reduce the risk of developing drug resistance, all anti-HIV drugs should be taken every day exactly as prescribed and directed. If doses are delayed, missed, or not taken as prescribed, levels of AZT in the blood may fall too low. If this happens, resistant virus can develop. If you find you are having problems taking your medications as directed, speak to your doctor and nurse about this.
They can find ways to help you. When HIV becomes resistant to one drug in a class, it sometimes becomes resistant to other drugs in that class. This is called cross-resistance. Feel free to talk with your doctor about your current and future treatment options.
To help you decide what these future therapies might be, at some point your doctor can have a small sample of your blood analysed using resistance testing. Should HIV in your body become resistant to AZT, your doctor, with the help of resistance testing, can help put together a new treatment regimen for you. The fixed-dose combinations Combivir and Trizivir are single tablets which combine AZT with other anti-HIV drugs, reducing the number of pills that need to be taken.
Pancreatitis inflammation of the pancreas : Zidovudine may cause or worsen pancreatitis. If you have a history of or are at risk for developing pancreatitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you develop signs of pancreatitis e. Red blood cells: Pure red cell aplasia is a rare bone marrow disorder characterized by a reduction in red blood cells produced by the bone marrow. Symptoms include pallor, weakness, shortness of breath, heart palpitations, and decreased blood pressure.
If you experience any of these symptoms contact your doctor immediately. Zidovudine may also cause low levels of red blood cells without causing red cell aplasia.
This usually happens after this medication has been taken for more than 4 to 6 weeks. Your doctor should order regular blood tests to monitor for changes in the numbers of blood cells during treatment. If you experience symptoms of reduced red blood cell count anemia such as shortness of breath, feeling unusually tired or pale skin, contact your doctor as soon as possible.
Reduced white blood cells: Zidovudine can cause low levels of white blood cells. If you experience symptoms of an infection e. If you have low levels white blood cells, your doctor may consider a different combination of medications to treat your condition.
Stopping the medication: If you stop taking this medication, your HIV infection could get worse. Take the medication exactly as prescribed by your doctor and do not stop taking the medication without checking with your doctor first.
Pregnancy: The use of zidovudine after the first 14 weeks of pregnancy does not appear to increase the risk of birth defects. Zidovudine is used by pregnant women with HIV infection to prevent transmission of the virus to the unborn child.
Breast-feeding: Zidovudine passes into breast milk. Women who have HIV infection are cautioned against breast-feeding because of the risk of passing HIV to a baby who does not have the infection. If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter non-prescription , and herbal medications you are taking. Also tell them about any supplements you take.
Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. All material copyright MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Source: www. About this Medication. How does this medication work? What will it do for me? Acne Doctor Discussion Guide. Acne: Fact vs Myth Quiz.
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