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zidovudine (Intravenous route)

Pronunciation

zye-DOE-vue-deen

Intravenous route(Solution)

Zidovudine has been associated with hematologic toxicity, including neutropenia and severe anemia, particularly in patients with advanced HIV disease. Prolonged use of zidovudine has been associated with symptomatic myopathy. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported .

Commonly used brand name(s)

In the U.S.

  • Retrovir

Available Dosage Forms:

  • Solution

Therapeutic Class: Antiretroviral Agent

Pharmacologic Class: Nucleoside Reverse Transcriptase Inhibitor

Uses For zidovudine

Zidovudine (also known as AZT) injection is used in combination with other anti-virus medicines in the treatment of the infection caused by the human immunodeficiency virus (HIV). HIV is the virus responsible for acquired immune deficiency syndrome (AIDS). Zidovudine injection is used to slow the progression of disease in patients infected with HIV who have advanced symptoms, early symptoms, or no symptoms at all. zidovudine also is used to help prevent pregnant women who have HIV from passing the virus to their babies during pregnancy and at birth.

Slideshow: Flashback: FDA Drug Approvals 2013

Zidovudine injection will not cure or prevent HIV infection or AIDS; however, it helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay the development of problems usually related to AIDS or HIV disease. Zidovudine injection will not keep you from spreading HIV to other people. People who receive zidovudine may continue to have the problems usually related to AIDS or HIV disease.

zidovudine is available only with your doctor's prescription.

Before Using zidovudine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For zidovudine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to zidovudine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of zidovudine injection in children.

Geriatric

Although appropriate studies on the relationship of age to the effects of zidovudine injection have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related liver, kidney, or heart problems which may require caution and an adjustment of dosage in patients receiving zidovudine injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving zidovudine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using zidovudine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine

Using zidovudine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Clarithromycin
  • Dapsone
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Flucytosine
  • Ganciclovir
  • Interferon Alfa
  • Pyrazinamide
  • Pyrimethamine
  • Ribavirin
  • Stavudine
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome

Using zidovudine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetaminophen
  • Fluconazole
  • Interferon Beta-1a
  • Methadone
  • Nelfinavir
  • Probenecid
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Tipranavir
  • Valproic Acid

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of zidovudine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Blood problems (e.g., anemia, neutropenia, or pancytopenia) or
  • Bone marrow problems or
  • Muscle disorder—Use with caution. May make these conditions worse.
  • Kidney disease or
  • Liver disease—Effects may be increased because of slow removal of zidovudine injection from the body.

Proper Use of zidovudine

A nurse or other trained health professional will give you zidovudine. zidovudine is given through a needle placed in one of your veins.

Your doctor may give you a few doses of zidovudine until your condition improves, and then you may be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using zidovudine

It is very important that your doctor check you or your child's progress at regular visits to make sure that zidovudine is working properly. Blood tests may be needed to check for unwanted effects.

Do not receive zidovudine if you are also using any combination medicines that also contain zidovudine (e.g., Combivir® or Trizivir®). To do so may increase the amount of zidovudine in your body which may cause serious side effects. Also, do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Zidovudine injection may cause blood problems. These problems may result in a greater chance of certain infections and slow healing. Therefore, you or your child should be careful when using regular toothbrushes, dental floss, and toothpicks not to damage your gums. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

Check with your doctor if you have muscle pain, tenderness, wasting, or unusual tiredness or weakness while you are receiving zidovudine.

Two rare but serious reactions to zidovudine are lactic acidosis (too much acid in the blood) and liver toxicity, which includes an enlarged liver. These are more common if you are female, very overweight (obese), or have been taking anti-HIV medicines for a long time. Call your doctor right away if you or your child have more than one of these symptoms: abdominal discomfort or cramping; dark urine; decreased appetite; diarrhea; general feeling of discomfort; light-colored stools; muscle cramping or pain; nausea; unusual tiredness or weakness; trouble breathing; vomiting; or yellow eyes or skin.

When you or your child start taking HIV medicines, your immune system may get stronger. If you have infections that are hidden in your body (e.g., pneumonia or tuberculosis), you may notice new symptoms when your body tries to fight them. If this occurs, tell your doctor right away.

You should not breastfeed if you have HIV or AIDS, because you may give the infection to your baby through your breast milk.

Zidovudine injection does not decrease the risk of transmitting the HIV infection to others through sexual contact or by contamination through blood. HIV may be spread to others through infected body fluids, including blood, vaginal fluid, or semen. If you are infected, it is best to avoid any sexual activity involving an exchange of body fluids with other people. If you do have sex, always wear (or have your partner wear) a condom (“rubber”). Only use condoms made of latex or polyurethane and use them every time you have contact with semen, vaginal secretions, or blood. Also, do not share needles with anyone or use dirty needles. If you have any questions about this, check with your doctor.

zidovudine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Abdominal pain
  • black, tarry stools
  • chills
  • cough
  • feeling of fullness
  • fever
  • lower back or side pain
  • painful or difficult urination
  • pale skin
  • right upper abdominal pain and fullness
  • shortness of breath
  • sore throat
  • swelling or inflammation of the mouth
  • swollen lymph nodes
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • wheezing
Less common
  • Troubled breathing with exertion
Incidence not known
  • Abdominal discomfort
  • back, leg, or stomach pains
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine
  • blurred vision or other change in vision
  • bone pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • burning, tingling, numbness or pain in the hands, arms, feet, or legs
  • clay-colored stools
  • constipation
  • cough or hoarseness
  • convulsions
  • dark-colored urine
  • decreased appetite
  • decreased urine output
  • diarrhea
  • difficult or labored breathing
  • difficulty in moving
  • difficulty in swallowing
  • dilated neck veins
  • dizziness
  • extreme fatigue
  • fainting
  • fast, irregular, or pounding heartbeat
  • fast, shallow breathing
  • general body swelling
  • general feeling of discomfort or illness
  • general tiredness and weakness
  • headache
  • high fever
  • hives
  • increased need to urinate
  • indigestion
  • irregular breathing
  • irritation or soreness of the mouth
  • joint or muscle pain
  • lack of coordination
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • muscle pain or cramping
  • muscle spasm or stiffness
  • muscular pain, tenderness, wasting, or weakness
  • nausea or vomiting
  • nosebleeds
  • pain
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • passing urine more often
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness, soreness, or itching skin
  • runny nose
  • sensation of pins and needles
  • shakiness in the legs, arms, hands, or feet
  • shivering
  • skin rash
  • sleepiness
  • sores, welting, or blisters
  • stabbing pain
  • sweating
  • swollen joints
  • swollen or painful glands
  • tightness in the chest
  • trembling or shaking of the hands or feet
  • trouble sleeping
  • unexplained bleeding or bruising
  • unpleasant breath odor
  • vomiting of blood
  • weight gain
  • yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Lack or loss of strength
Incidence not known
  • Acid or sour stomach
  • actions that are out of control
  • belching
  • bloated
  • change in taste or bad, unusual, or unpleasant (after) taste
  • changes in skin color
  • difficulty seeing at night
  • discouragement
  • dizziness or lightheadedness
  • excess air or gas in the stomach or intestines
  • fear or nervousness
  • feeling of constant movement of self or surroundings
  • feeling sad or empty
  • hearing loss
  • heartburn
  • impaired vision
  • increased sensitivity of the eyes to sunlight
  • irritability
  • itching skin
  • loss of interest or pleasure
  • mood or mental changes
  • pain or tenderness around the eyes and cheekbones
  • passing gas
  • redness of the skin
  • sensation of spinning
  • sleepiness or unusual drowsiness
  • sleeplessness
  • sneezing
  • stuffy nose
  • swelling of the breasts or breast soreness in both females and males
  • talking, feeling, and acting with excitement
  • trouble concentrating
  • unable to sleep
  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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