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Zidovudine

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Zidovudine (or AZT) was the first drug ever used to successfully treat HIV. Many treatment-experienced people received AZT monotherapy in the past and have developed resistanceHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. to the drug.

AZT is still precribed, usually in combination with another NRTIA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different.  lamivudine (Combivir), but is not the  ideal first-line drug due to it's links to lipodystrophy.

Zidovudine and lamivudine remains as the preferred option in pregnant women.

Generic name: zidovudine (AZT)
Pronunciation:zye-DOE-vyoo-deen
Brand name:Retrovir
Also known as:ZDV
Zidovir
Drug class:nucleoside analogue
Pregnancy safe?Safe for use in pregnancy.
Pediatric dosing?Available in doses suitable for children and/or young people.
Availability in Australia:
  • Available on the Pharmaceutical Benefits Scheme (PBS) through S100 prescribers.
  • This drug may be available through clinical trials in Australia.
  • You may be able to import this drug from overseas for your personal use.
Presentation:100mg capsule; 250mg capsule; 10mg per mL, 200 mL syrup
What the treatment guidelines say:

Bone marrow suppression, manifested by macrocytic anemia and/or neutropenia, is seen in some patients. Zidovudine also is associated with gastrointestinal toxicity, fatigue, and possibly mitochondrial toxicity, including lactic acidosis/hepatic steatosis and lipoatrophy.

In the 934 study, participants who took zidovudine had significantly less limb fat at 96 and 144 weeks than those who took tenofovir, and there was a significant loss of fat among zidovudine recipients between 48, 96, and 144 weeks.

In ACTG 5142, limb fat was lowest in patients treated with stavudine, but those treated with zidovudine had significantly less limb fat than those treated with tenofovir [8]. Primarily because of its greater toxicity compared with tenofovir/emtricitabine, zidovudine/lamivudine is now considered an alternative rather than a preferred dual-NRTI option (BI).

However, zidovudine/lamivudine remains as the preferred option in pregnant women. This dual-NRTI has the most safety and efficacy data for both mother and newborn.

Links:

Like most anti-HIV drugs, zidovudine must be taken in combination with other drugs to be completely effective. Commonly, zidovudine is combined with one other nucleoside (NRTI) drug and either a protease inhibitor or non-nucleoside, although other combinations are sometimes used. Your doctor will advise you on the right combination of drugs to suit your circumstances.

Dosage

The normal adult dose is one 250mg capsule taken twice a day.

Regardless of what you read on this website or elsewhere, you should always take your medications according to your doctor's instructions. If you're unsure, speak to your doctor or pharmacist.

With or without food?

Zidovudine may be taken with or without food.

Side effects

All drugs can produce side effects in some people. These may be mild, moderate or severe, so you should be aware of potential side effects before starting any drug, and speak to your doctor if you experience side effects that concern you.

  • Common side effects may include nausea (upset stomach, feeling sick to the stomach), vomiting, headache, fatigue, dizziness, weakness, muscle pain, lipodystrophy.
  • Less common side effects may include blood disorders, muscle damage.

    • It's unlikely you will experience all of these side effects, and you may not experience any side effects at all. Before starting any new drug, ask your doctor about side effects you might experience and discuss strategies for dealing with side effects if they do occur. If you experience any significant side effect you should continue taking your medicine and see your doctor as soon as possible.

Interactions with other drugs

Avoid using with Ribavirin or monitor for side effects, and any effect on viral load. Monitor for adverse side effects if you are also using methadone. Should not be used with stavudine (d4T.
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Getting spine: the nucleoside backbone

Positive Living article • Paul Kidd • 19 January 2006

Nucleoside analoguesA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different. are the backbone of successful anti-HIV treatments. This article examines some of the issues involved in selecting the best nucleoside backbone. read more »

Beyond the barbs

Positive Living article • Jim Arachne • 19 December 2004

Peripheral neuropathy (PN) is a debilitating treatment side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. and one of the common reasons for people stopping their anti-HIV medication. read more »

The power of one

Positive Living article • Paul Kidd • 15 December 2003

We all want simpler treatment regimens with fewer side effects and no meal restrictions, right? Well how does once-a-day treatment sound? As PAUL KIDD reports, it may be closer than you think. read more »

The table below shows all the clinical trials in the database with the keyword zidovudine (AZT).

Short titleStatus
ALTAIR (Truvada for treatment-naive) Reported
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This Treatments database entry was first published on 22 May 2009 — more than four years ago.

While the content of this treatments database entry was checked for accuracy at the time of publication, NAPWHA recommends checking to determine whether the information is the most up-to-date available, especially when making decisions which may affect your health.

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