zidovudine

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

zidovudine (non-CYTOTOXIC hazardous)

Hazardous Symbol

Refer to the Procedure for Safe Handling of Hazardous Drugs (CYTOTOXIC and non-CYTOTOXIC) and Safe Handling of Hazardous Drugs Policy on the LHSC Intranet

Indication

  • To reduce the risk of HIV vertical transmission from mother to baby

Dosage Guidelines

  • Prophylaxis at birth: start within 6 to 12 hours; continue for 4-6 weeks
Gestational Age (weeks)Postnatal Age (days)Dose
Less than 300 to 28

1.5 mg/kg/dose IV q12 hours or

2 mg/kg/dose ORAL q12 hours

Less than 30Greater than 28

2.3 mg/kg/dose IV q12 hours or

3 mg/kg/dose ORAL q12 hours

30 – 34+6

0 to 14

1.5 mg/kg/dose IV q12 hours or

2 mg/kg/dose ORAL q12 hours

30 – 34+6

Greater than 14

2.3 mg/kg/dose IV q12 hours or

3 mg/kg/dose ORAL q12 hours

35 weeks or greaterALL

3 mg/kg/dose IV q12 hours or

4 mg/kg/dose ORAL q12 hours

Administration

  • ORAL
  • IV intermittent infusion over 30 minutes

Adverse Effects

  • Anemia (decreased hemoglobin after 2 to 4 weeks), granulocytopenia (6 to 8 weeks), thrombocytopenia.  A dose interruption or transfusion may be needed until evidence of bone marrow recovery occurs.  Risk increased in hepatic impairment.
  • Other common side effects include headache, nausea, vomiting, malaise, fatigue, fever and abnormal ECG

Comments

  • Monitor CBC at beginning of therapy, then every other week

Supplied As

  • 10 mg/mL oral syrup
  • 4 mg/mL IV syringe prepared by Pharmacy
References
  1. LexiComp Sick Kids
  2. LexiComp Pediatric and Neonatal