WARNING

Zidovudine (ZDV), while effective in treating HIV, comes with potential risks and side effects. Here is a brief overview of the risks associated with taking ZDV:

• Bone Marrow Suppression: ZDV can lead to bone marrow suppression, resulting in decreased production of red blood cells, white blood cells, and platelets. This can lead to anemia, neutropenia, and thrombocytopenia.
• Gastrointestinal Effects: Nausea and vomiting are common gastrointestinal side effects of ZDV.
• Lactic Acidosis: In rare cases, ZDV has been associated with lactic acidosis, a serious condition characterized by an accumulation of lactic acid in the body. Symptoms may include weakness, rapid breathing, and abdominal pain.
• Myopathy and Neuropathy: ZDV use has been linked to muscle weakness (myopathy) and peripheral neuropathy, which can cause symptoms such as muscle pain, weakness, and tingling or numbness in the extremities.
• Liver Problems: Elevated liver enzymes and hepatomegaly (enlarged liver) have been reported in some individuals taking ZDV.
• Mitochondrial Toxicity: ZDV may cause mitochondrial toxicity, which can affect the function of cellular energy-producing structures called mitochondria.
• Hematologic Effects in Pregnancy: ZDV is often used to prevent mother-to-child transmission of HIV during pregnancy. However, prolonged use during pregnancy has been associated with an increased risk of anemia in both the mother and the newborn.

It’s important for individuals taking ZDV to be closely monitored by healthcare professionals, and any concerning symptoms should be promptly reported. The decision to use ZDV and the management of its potential side effects should be individualized based on a patient’s overall health and the specific circumstances of their HIV infection. Patients should discuss any concerns with their healthcare provider.

Why is this medication prescribed?

Zidovudine (ZDV), also known as azidothymidine (AZT), is an antiretroviral medication that is primarily prescribed for the treatment of HIV (Human Immunodeficiency Virus) infection. It belongs to a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs). Zidovudine works by inhibiting the activity of reverse transcriptase, an enzyme that the virus needs to replicate within human cells.

Indications for Zidovudine:

• HIV Treatment: Zidovudine is used in combination with other antiretroviral medications for the treatment of HIV infection. It is a part of the standard therapy for managing the progression of the virus, improving immune function, and reducing the risk of opportunistic infections.
• Prevention of Mother-to-Child Transmission: Zidovudine is often prescribed to pregnant women with HIV to reduce the risk of transmitting the virus to their unborn child. It may also be given to the newborn for a short period after birth.

How should this medicine be used?

Here are some general guidelines for using Zidovudine:

• Combination Therapy: Zidovudine is rarely used alone for HIV treatment. It is typically prescribed as part of a combination regimen with other antiretroviral drugs. This combination approach is known as Highly Active Antiretroviral Therapy (HAART) or antiretroviral therapy (ART).
• Oral Administration: Zidovudine is usually taken orally in the form of tablets or capsules.
• Dosage: The specific dosage of zidovudine can vary based on factors such as the patient’s weight, age, renal function, and other medications they are taking. The dosage is often adjusted by healthcare providers to optimize effectiveness and minimize side effects.
• Timing of Administration: Zidovudine is typically taken two to three times per day with or without food. It’s important to follow the prescribed dosing schedule consistently.
• Monitoring: Regular monitoring of blood counts, liver function, and other relevant parameters is essential during zidovudine therapy. This helps healthcare providers detect and manage potential side effects promptly.
• Pregnancy Considerations: In pregnant individuals with HIV, zidovudine is often a component of the regimen used to prevent mother-to-child transmission. The dosage and duration of use during pregnancy are determined based on the specific circumstances and health of the mother and fetus.

Patients should always follow the instructions provided by their healthcare provider and inform them of any side effects or concerns during the course of treatment. Additionally, individuals should not adjust their medication dosage or stop taking zidovudine without consulting their healthcare provider, as discontinuation can lead to a resurgence of viral activity.

Other uses for this medicine

While zidovudine is primarily used for the treatment of HIV infection, it has been investigated and used in certain other situations:

• Prevention of Vertical Transmission: Zidovudine has been used to reduce the risk of vertical transmission of HIV from mother to child during childbirth and breastfeeding.
• Post-Exposure Prophylaxis (PEP): Zidovudine may be part of a PEP regimen, which involves taking antiretroviral medications after potential exposure to HIV to prevent infection.
• Occupational Exposure: In some cases of occupational exposure to HIV (e.g., healthcare workers following accidental needlestick injuries), zidovudine may be used as part of a PEP strategy.
• Combination Therapies: Zidovudine is often used in combination with other antiretroviral drugs for more effective HIV treatment.

What special precautions should I follow?

Special Precautions for Zidovudine (ZDV):

• Monitoring: Regular monitoring of blood counts, liver function, and overall health is crucial during zidovudine therapy. This helps detect any potential side effects early on.
• Bone Marrow Suppression: Zidovudine can cause bone marrow suppression, leading to anemia, neutropenia, and thrombocytopenia. Healthcare providers should closely monitor blood cell counts, especially in the early stages of treatment.
• Mitochondrial Toxicity: Zidovudine may cause mitochondrial toxicity, which can affect various organs. Patients with pre-existing mitochondrial dysfunction or certain medical conditions may need special attention and monitoring.
• Lactic Acidosis: Although rare, zidovudine has been associated with lactic acidosis, a serious metabolic complication. Symptoms include weakness, rapid breathing, abdominal pain, and other signs of metabolic dysfunction.
• Myopathy and Neuropathy: Zidovudine use has been linked to muscle weakness (myopathy) and peripheral neuropathy. Patients experiencing muscle pain, weakness, or numbness should seek medical attention.
• Pregnancy and Breastfeeding: Zidovudine is often used in pregnant individuals with HIV to prevent transmission to the baby. The benefits and risks of medication use during pregnancy should be carefully evaluated by healthcare providers. Zidovudine can be excreted in breast milk, so its use during breastfeeding should be discussed with healthcare providers.
• Drug Interactions: Zidovudine can interact with other medications. It’s important to inform healthcare providers about all medications, including over-the-counter drugs and herbal supplements, being taken concurrently.
• Hepatic Impairment: Zidovudine is primarily eliminated through the kidneys, but liver function should still be monitored, especially in individuals with pre-existing liver conditions.

Patients should communicate openly with their healthcare provider about their medical history, any existing conditions, and any medications or supplements they are taking. Following prescribed dosages and reporting any unusual symptoms promptly is essential for the safe and effective use of zidovudine.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with zidovudine. However, maintaining a healthy and balanced diet is important for overall well-being, especially when managing a chronic condition like HIV.

What should I do if I forget a dose?

If you miss a dose of zidovudine, take it as soon as you remember. However, if it’s almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.

What side effects can this medication cause?

Zidovudine (ZDV), like many medications, can cause side effects. It’s important to note that not everyone will experience these side effects, and some individuals may tolerate the drug well. Common and serious side effects associated with zidovudine include:

Common Side Effects:

• Nausea and Vomiting: Gastrointestinal symptoms like nausea and vomiting are relatively common.
• Headache: Some individuals may experience headaches while taking zidovudine.
• Fatigue: Feeling tired or fatigued is a reported side effect.
• Muscle Weakness or Pain: Zidovudine use has been associated with myopathy, which can cause muscle weakness or pain.
• Hematologic Effects: Zidovudine can lead to bone marrow suppression, resulting in anemia, neutropenia (low white blood cell count), and thrombocytopenia (low platelet count).

Less Common but Potentially Serious Side Effects:

• Lactic Acidosis: Although rare, zidovudine use has been associated with lactic acidosis, a serious condition characterized by an excess buildup of lactic acid in the body. Symptoms include weakness, rapid breathing, abdominal pain, and other metabolic disturbances.
• Hepatomegaly: Enlargement of the liver (hepatomegaly) and elevated liver enzymes have been reported.
• Peripheral Neuropathy: Some individuals may experience tingling, numbness, or pain in the extremities, known as peripheral neuropathy.
• Severe Allergic Reactions: While uncommon, severe allergic reactions such as rash, fever, and difficulty breathing can occur. Seek medical attention immediately if you experience these symptoms.
• Bone Marrow Suppression: In some cases, zidovudine can cause a decrease in blood cell counts, leading to anemia, neutropenia, and thrombocytopenia.
• Mitochondrial Toxicity: Zidovudine may cause mitochondrial toxicity, affecting cellular energy production.

Pregnancy-Specific Considerations:

In pregnant individuals, zidovudine may be used to prevent mother-to-child transmission of HIV. However, prolonged use during pregnancy has been associated with an increased risk of anemia in both the mother and the newborn.

It’s essential for individuals taking zidovudine to be aware of potential side effects and promptly report any concerning symptoms to their healthcare provider. Healthcare providers will closely monitor patients on zidovudine and adjust treatment as needed. It’s crucial not to discontinue the medication or adjust the dosage without consulting with a healthcare professional. The benefits of HIV treatment generally outweigh the risks of side effects, and healthcare providers can work with patients to manage and mitigate these effects when necessary.

What should I know about storage and disposal of this medication?

Storage and Disposal of Zidovudine (ZDV):

• Storage:
  • Store zidovudine at room temperature away from moisture, heat, and light.
  • Keep the medication in its original packaging to protect it from environmental factors.
• Disposal:
  • Follow local regulations for the proper disposal of unused or expired medications.
  • Do not flush zidovudine down the toilet unless instructed to do so.
  • Take unused or expired medications to a drug take-back program or a pharmacy that offers medication disposal services.

In case of emergency/overdose

In the case of an overdose or emergency, seek medical attention immediately. If you suspect an overdose or experience severe symptoms, such as difficulty breathing or loss of consciousness, call your local emergency number (e.g., 911 in the United States) or go to the nearest emergency room.

What other information should I know?

• Regular Follow-ups: Attend all scheduled follow-up appointments with your healthcare provider. Regular monitoring is essential to assess the effectiveness of the medication and manage any potential side effects.
• Medical History: Inform your healthcare provider of your complete medical history, including any pre-existing conditions, allergies, or medications you are currently taking. This information can help in managing potential interactions or contraindications.
• Drug Interactions: Zidovudine may interact with other medications. Inform your healthcare provider about all drugs, including prescription and over-the-counter medications, as well as herbal supplements.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the use of zidovudine with your healthcare provider. The benefits and risks will be carefully evaluated to ensure the well-being of both the mother and the child.
• Adherence to Treatment Plan: Take zidovudine exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking the medication without consulting your healthcare professional.
• Transmission Risk Reduction: If you are taking zidovudine to reduce the risk of transmitting HIV to your baby during childbirth, follow your healthcare provider’s instructions carefully.
• Lifestyle Considerations: Adopt a healthy lifestyle, including a balanced diet, regular exercise, and avoiding harmful substances. These lifestyle factors can contribute to overall well-being, especially when managing a chronic condition like HIV.

Remember that the information provided here is general in nature, and individual circumstances may vary. Always follow the specific instructions given by your healthcare provider and consult them for personalized advice related to your treatment with zidovudine.