{"id":2290,"date":"2023-06-25T17:55:36","date_gmt":"2023-06-25T17:55:36","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/zidovudine\/"},"modified":"2023-06-25T18:00:40","modified_gmt":"2023-06-25T18:00:40","slug":"zidovudine","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/zidovudine\/","title":{"rendered":"Zidovudine"},"content":{"rendered":"

<\/p>\n

CLINICAL USE<\/h3>\n

Nucleoside reverse transcriptase inhibitor: Treatment of HIV in combination with other antiretroviral drugs Prevention of maternal-foetal HIV transmission<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

Oral: 500\u2013600 mg daily in 2\u20133 divided doses IV: 1\u20132 mg\/kg every 4 hours<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           : 267.2<\/li>\n
  • %Protein binding                           : 34\u201338<\/li>\n
  • %Excreted unchanged in urine     : 8\u201325<\/li>\n
  • Volume of distribution (L\/kg)       : 1.6<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      : 1.1\/1. 4\u20133
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Give 100% of normal dose every 8 hours<\/li>\n
  • 10 to 20     : Give 100% of normal dose every 8 hours<\/li>\n
  • <10           : Give 50% of normal dose every 8 hours1
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                : Not dialysed. Dose as in GFR <10 mL\/min<\/li>\n
  • HD                     : Not dialysed. Dose as in GFR <10 mL\/min Give post dialysis<\/li>\n
  • HDF\/high flux   : Unknown dialysability. Dose as in GFR <10 mL\/min Give post dialysis<\/li>\n
  • CAV\/VVHD      : Not dialysed. Dose as in GFR 10 to 20 mL\/min
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Antibacterials: absorption reduced by clarithromycin; avoid concomitant use with rifampicin<\/li>\n
  • Anti-epileptics: phenytoin levels may be raised or lowered; concentration possibly increased by valproate (increased risk of toxicity)<\/li>\n
  • Antifungals: concentration increased by fluconazole<\/li>\n
  • Antivirals: profound myelosuppression with ganciclovir \u2013 avoid if possible; extreme lethargy on administration of IV aciclovir; effects of stavudine inhibited \u2013 avoid concomitant use; concentration reduced by tipranavir
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    –<\/p>\n

    Route<\/h4>\n

    IV, oral<\/p>\n

    Rate of Administration<\/h4>\n

    1 hour<\/p>\n

    Comments<\/h4>\n

    Dilute with glucose 5% infusion to give a final concentration of 2 mg\/mL or 4 mg\/mL<\/p>\n

    OTHER INFORMATION<\/h4>\n

    Dialysis has little effect on zidovudine, presumably because of rapid metabolism. The glucuronide metabolite (T\u00bd =1 hour) has no antiviral activity and will be significantly removed by dialysis Patients with severe renal failure have 50% higher maximum plasma concentrations 90% of a dose is excreted renally, mostly as the glucuronide. There is substantial accumulation of this metabolite in renal failure Main risk in renal impairment is haematological toxicity<\/li>\n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Nucleoside reverse transcriptase inhibitor: Treatment of HIV in<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-2290","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2290","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=2290"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2290\/revisions"}],"predecessor-version":[{"id":2304,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/2290\/revisions\/2304"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=2290"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=2290"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=2290"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}