Retrovir: The Gold Standard in HIV-1 Management
| Product dosage: 100mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | $0.97 | $58.48 (0%) | 🛒 Add to cart |
| 90 | $0.95 | $87.72 $85.14 (3%) | 🛒 Add to cart |
| 120 | $0.91 | $116.96 $109.22 (7%) | 🛒 Add to cart |
| 180 | $0.84 | $175.44 $151.36 (14%) | 🛒 Add to cart |
| 270 | $0.82 | $263.16 $221.02 (16%) | 🛒 Add to cart |
| 360 | $0.78
Best per pill | $350.88 $282.08 (20%) | 🛒 Add to cart |
| Product dosage: 300mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $5.33 | $53.32 (0%) | 🛒 Add to cart |
| 20 | $4.94 | $106.64 $98.90 (7%) | 🛒 Add to cart |
| 30 | $4.62 | $159.96 $138.46 (13%) | 🛒 Add to cart |
| 60 | $4.41 | $319.92 $264.88 (17%) | 🛒 Add to cart |
| 90 | $4.06 | $479.88 $365.50 (24%) | 🛒 Add to cart |
| 120 | $3.87 | $639.84 $464.40 (27%) | 🛒 Add to cart |
| 180 | $3.61 | $959.76 $650.16 (32%) | 🛒 Add to cart |
| 270 | $3.44 | $1439.64 $928.80 (35%) | 🛒 Add to cart |
| 360 | $3.31
Best per pill | $1919.52 $1191.96 (38%) | 🛒 Add to cart |
Retrovir (zidovudine) is a nucleoside reverse transcriptase inhibitor (NRTI) indicated, in combination with other antiretroviral agents, for the treatment of human immunodeficiency virus type 1 (HIV-1) infection. As the first antiretroviral medication approved by the FDA, it represents a cornerstone of highly active antiretroviral therapy (HAART), fundamentally altering the prognosis of HIV from a fatal diagnosis to a manageable chronic condition. Its established efficacy profile and extensive clinical history make it a critical component in both treatment-naïve and experienced patient regimens, working to suppress viral replication, increase CD4 cell counts, and slow disease progression.
Features
- Active pharmaceutical ingredient: Zidovudine (AZT).
- Available in 100 mg hard gelatin capsules and a 10 mg/mL syrup formulation.
- Mechanism of Action: A thymidine analogue that inhibits the reverse transcriptase enzyme of HIV-1.
- Pharmacokinetics: Rapidly absorbed with a bioavailability of approximately 60-70%; crosses the blood-brain barrier.
- Metabolism: Primarily hepatic via glucuronidation (UGT2B7).
- Excretion: Renal, with a half-life of 0.5 to 3 hours.
Benefits
- Proven Viral Suppression: Effectively reduces HIV-1 RNA viral load, a key marker for treatment success.
- Immunological Restoration: Contributes to the recovery and maintenance of CD4+ T-cell counts, strengthening the immune system.
- Disease Progression Mitigation: Significantly reduces the risk of developing acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections and malignancies.
- Perinatal Transmission Prevention: A critical component in regimens to reduce the risk of maternal-fetal HIV transmission.
- Extensive Clinical Legacy: Over three decades of real-world data and clinical experience inform its safe and effective use.
- Formulation Versatility: Availability in both capsule and liquid forms accommodates diverse patient needs, including pediatric dosing and those with swallowing difficulties.
Common use
Retrovir is a foundational agent used in combination antiretroviral therapy (cART) for the management of HIV-1 infection in adults and children. It is a key component of first-line and subsequent treatment regimens. A primary and critical non-treatment use is the prevention of maternal-fetal HIV transmission during pregnancy, labor, and delivery, as well as for neonatal prophylaxis.
Dosage and direction
Dosing must be individualized based on clinical circumstances, concomitant medications, and patient tolerance. It is always used as part of a combination regimen.
- Adults: The recommended oral dose is 300 mg twice daily or 200 mg three times daily.
- Pediatric Patients (aged 4 weeks to 18 years): Dosing is based on body weight and body surface area. The recommended dose is 160 mg/m²/dose (maximum 200 mg) three times daily or 240 mg/m²/dose (maximum 300 mg) twice daily. Consultation with a pediatric HIV specialist is mandatory.
- Prevention of Maternal-Fetal HIV Transmission: A specific dosing regimen is used for the pregnant person and the newborn infant, which is distinct from chronic treatment dosing. This must be managed by an obstetrician specializing in HIV.
- Administration: Can be taken with or without food. The oral syrup should be administered using the supplied measuring cup for accuracy.
Precautions
- Hematologic Toxicity: Retrovir has been associated with hematologic toxicity including neutropenia and severe anemia, particularly in patients with advanced HIV disease. Frequent blood monitoring is required, especially during the first three months of therapy.
- Myopathy: Prolonged use has been associated with symptomatic myopathy and myositis.
- Lactic Acidosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with NRTIs, including Retrovir. Use with caution in patients with known risk factors for liver disease.
- Fat Redistribution: Redistribution/accumulation of body fat (lipodystrophy) has been observed in patients receiving antiretroviral therapy.
- Immune Reconstitution Inflammatory Syndrome (IRIS): Has been reported in patients treated with combination antiretroviral therapy.
- Renal/Hepatic Impairment: Dose adjustment may be necessary in patients with severely impaired renal function or end-stage liver disease.
Contraindications
Retrovir is contraindicated in patients with:
- A history of a life-threatening hypersensitivity reaction (e.g., anaphylaxis, Stevens-Johnson syndrome) to any of the components of the product.
- Potentially fatal interactions exist with other drugs; see Drug Interactions section.
Possible side effect
Adverse reactions are often linked to the intensity of treatment and the patient’s disease stage. Common and serious side effects include:
- Very Common (>10%): Headache, nausea, malaise, anemia, neutropenia.
- Common (1-10%): Vomiting, anorexia, abdominal pain, diarrhea, dizziness, insomnia, myalgia, fever, rash, elevated liver enzymes.
- Uncommon (<1%): Lactic acidosis, hepatomegaly with steatosis, myopathy, myositis, pigmentation of nails, seizures, pancreatitis, cardiomyopathy.
Drug interaction
Retrovir is subject to significant and potentially dangerous drug interactions. Key interactions include:
- Contraindicated Combination: Stavudine (d4T) - Antagonistic antiviral effect; concomitant use is prohibited.
- Other Nucleoside Analogues: Use with caution in combination with other drugs that may cause hematologic toxicity, neuropathy, or pancreatitis (e.g., didanosine).
- Nephrotoxic Drugs: Drugs like aminoglycosides, foscarnet, or pentamidine may increase the risk of toxicity.
- UGT2B7 Inhibitors/Inducers: Drugs that inhibit glucuronidation (e.g., valproic acid, fluconazole) can increase zidovudine levels. Inducers may decrease its efficacy.
- Ribavirin and Interferon-alpha: Antagonistic antiviral effect; concomitant use is not recommended.
- A comprehensive review of the patient’s complete medication list, including over-the-counter drugs and supplements, is essential before initiation.
Missed dose
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. The patient should not take a double dose to make up for a missed one. Maintaining a consistent schedule is critical for effective viral suppression.
Overdose
- Symptoms: Reported events in overdose include nausea, vomiting, and hematologic disturbances. Hepatic components may also be affected. Lactic acidosis may occur with large overdoses.
- Management: There is no specific antidote for Retrovir overdose. Treatment consists of general supportive measures, including monitoring of hematologic parameters and vital signs. Hemodialysis and peritoneal dialysis are not effective in removing zidovudine, but enhanced elimination by glucuronidation may be of some benefit.
Storage
- Store capsules and syrup at a controlled room temperature, 20°C to 25°C (68°F to 77°F).
- Keep the bottle tightly closed. Protect from light and moisture.
- The oral syrup may be stored at room temperature or refrigerated. Do not freeze. Discard any unused portion 35 days after the bottle is first opened.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. It is not exhaustive. The prescribing physician is the ultimate source of information for a patient’s specific treatment plan, including indications, dosage, warnings, and precautions. Patients must never adjust their medication regimen without direct consultation with their healthcare provider.
Reviews
“Retrovir remains a workhorse in our antiretroviral armamentarium. Its long-term safety data is unparalleled, and it continues to be a reliable option in carefully selected regimens, particularly where its CNS penetration is a desired attribute.” – Infectious Disease Specialist, 15 years of experience.
“In pediatric HIV care, the availability of a well-studied liquid formulation is invaluable. While we monitor for hematologic parameters diligently, its role in keeping our youngest patients healthy is undeniable.” – Pediatric HIV Specialist.
“From the dark days of the epidemic to the modern era of U=U (Undetectable = Untransmittable), zidovudine was there. It’s a testament to the drug’s foundational role that it is still relevant in today’s treatment landscape.” – Clinical Virologist.