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Zidovudine Disease Interactions

There are 4 disease interactions with zidovudine.

Major

AZT (applies to zidovudine) bone marrow suppression

Major Potential Hazard, High plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Zidovudine (AZT) may cause bone marrow toxicity, most commonly manifested as granulocytopenia and anemia, particularly in patients with advanced, symptomatic HIV disease. Thrombocytopenia not related to HIV may also occasionally occur. Zidovudine should be given with extreme caution to patients with preexisting bone marrow depression (indicated by a granulocyte count below 1000 cells/mm3 or hemoglobin less than 9.5 g/dL) or blood dyscrasias. Routine blood counts are recommended, and generally should occur more frequently in patients with advanced HIV disease. Dosage reductions may be necessary.

References

  1. Goldsmith JC, Irvine W "Reversible agranulocytosis related to azidothymidine therapy." Am J Hematol 30 (1989): 263-4
  2. Baum MK, Javier JJ, Mantero-Atienza E, et al. "Zidovudine-associated adverse reactions in a longitudinal study of asymptomatic HIV-1-infected homosexual males." J Acquir Immune Defic Syndr 4 (1991): 1218-26
  3. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome (2001):
  4. Moore RD, Fortgang I, Keruly J, Chaisson RE "Adverse events from drug therapy for human immunodeficiency virus disease." Am J Med 101 (1996): 34-40
View all 4 references
Major

AZT/telbivudine (applies to zidovudine) myopathy

Major Potential Hazard, High plausibility. Applicable conditions: Myoneural Disorder

Prolonged use of certain nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine and telbivudine may commonly cause myopathy, including rare cases of rhabdomyolysis. The myopathy may be dose-related and is characterized by persistent, unexplained muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values. Therapy with these NRTIs should be administered cautiously in patients with preexisting myopathy or a myoneural disorder, since it may delay the recognition or confound the diagnosis of a drug-induced musculoskeletal effect. Patients should be advised to report promptly any unusual muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. NRTI therapy should be interrupted if drug-related myopathy is suspected, and discontinued if myopathy is diagnosed.

References

  1. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome (2001):
  2. "Product Information. Tyzeka (telbivudine)." IDEC Pharmaceuticals Corporation (2006):
Major

NRTIs (applies to zidovudine) hepatotoxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Alcoholism, Liver Disease

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has been associated with the use of some nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. The use of abacavir is contraindicated in patients with moderate to severe hepatic impairment as its safety and efficacy has not been established on these patients.

References

  1. Yarchoan R, Mitsuya H, Pluda JM, et al. "The National Cancer Institute phase I study of 2',3'-dideoxyinosine administration in adults with AIDS-related complex: analysis of activity and toxicity profiles." Rev Infect Dis 12 (1990): s522-33
  2. Dolin R, Lambert JS, Morse GD, et al. "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  3. Lai KK, Gang DL, Zawacki JK, Cooley TP "Fulminant hepatic failure associated with 2',3'-dideoxyinosine (ddI)." Ann Intern Med 115 (1991): 283-4
  4. Dubin G, Braffman MN "Zidovudine-induced hepatotoxicity." Ann Intern Med 110 (1989): 85-6
  5. Shriner K, Goetz MB "Severe hepatoxicity in a patient receiving both acetaminophen and zidovudine." Am J Med 93 (1992): 94-6
  6. Gradon JD, Chapnick EK, Sepkowitz DV "Zidovudine-induced hepatitis." J Intern Med 231 (1992): 317-8
  7. Chen SC, Barker SM, Mitchell DH, et al. "Concurrent zidovudine-induced myopathy and hepatoxicity in patients treated for human immunodeficiency virus (HIV) infection." Pathology 24 (1992): 109-11
  8. "Product Information. Videx (didanosine)." Bristol-Myers Squibb (2002):
  9. "Product Information. HIVID (zalcitabine)." Roche Laboratories (2001):
  10. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome (2001):
  11. Pike IM, Nicaise C "The didanosine Expanded Access Program: safety analysis." Clin Infect Dis 16 (1993): S63-8
  12. Shintaku M, Nasu K, Shimizu T "Fulminant hepatic failure in an AIDS patient: possible zidovudine- induced hepatotoxicity." Am J Gastroenterol 88 (1993): 464-6
  13. Montaner JSG, Rachlis A, Beaulieu R, Gill J, Schlech W, Phillips P, Auclair C, Boulerice F, Schindzielorz A, Smaldone L, Wainber "Safety profile of didanosine among patients with advanced HIV disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program." J Acquir Immune Defic Syndr 7 (1994): 924-30
  14. "Product Information. Epivir (lamivudine)." Glaxo Wellcome (2001):
  15. "Product Information. Ziagen (abacavir)." Glaxo Wellcome (2001):
  16. Miller KD, Cameron M, Wood LV, Dalakas MC, Kovacs JA "Lactic acidosis and hepatic steatosis associated with use of stavudine: report of four cases." Ann Intern Med 133 (2000): 192-6
  17. Lhouri S, Cushing H "Lactic acidosis secondary to nucleoside analog antiretroviral therapy." Infect Med 17 (2000): 547-54
  18. Pai VB, Koranyi K, Nahata MC "Acute hepatitis and bleeding possibly induced by zidovudine and ritonavir in an infant with HIV infection." Pharmacotherapy 20 (2000): 1135-40
  19. Lonergan JT, Behling C, Pfander H, Hassanein TI, Mathews WC "Hyperlactatemia and hepatic abnormalities in 10 human immunodeficiency virus-infected patients receiving nucleoside analogue combination regimens." Clin Infect Dis 31 (2000): 162-6
  20. Kronenberg A, Riehle HM, Gunthard HF "Liver failure after long-term nucleoside antiretroviral therapy." Lancet 358 (2001): 759-601
  21. Boubaker K, Flepp M, Sudre P, et al. "Hyperlactatemia and Antiretroviral Therapy: The Swiss HIV Cohort Study." Clin Infect Dis 33 (2001): 1931-7
  22. Coghlan ME, Sommadossi JP, Jhala NC, Many WJ, Saag MS, Johnson VA "Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases." Clin Infect Dis 33 (2001): 1914-21
  23. "Product Information. Viread (tenofovir)." Gilead Sciences (2001):
  24. "Product Information. Baraclude (entecavir)." Bristol-Myers Squibb (2005):
View all 24 references
Major

NRTIs (applies to zidovudine) renal dysfunction

Major Potential Hazard, High plausibility.

Patients with clinically significant renal impairment may be at greater risk for toxicities and adverse effects from nucleoside reverse transcriptase inhibitors (NRTIs) due to decreased drug clearance. Dosage adjustments are recommended. In addition, these patients should be monitored closely during NRTI therapy, and dosages adjusted further if necessary.

References

  1. "Product Information. HIVID (zalcitabine)." Roche Laboratories (2001):
  2. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome (2001):
  3. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb (2001):
  4. "Product Information. Epivir (lamivudine)." Glaxo Wellcome (2001):
View all 4 references

Zidovudine drug interactions

There are 341 drug interactions with zidovudine.

Zidovudine alcohol/food interactions

There is 1 alcohol/food interaction with zidovudine.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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