POZ IRELAND
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POZ IRELAND
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ZIDOVUDINE (AZT)Retrovir® (Wellcome) Approved for use in HIV infection in combination with other antiviral drugs. DESCRIPTION: AZT is a nucleoside analogue that inhibits HIV reverse transcription, and the first antiretroviral drug approved for treatment of HIV disease. DOSE: Adults / adolescents: 300 mg (one tablet) twice a day. Paediatric: Oral - 120-160 mg/m2 every 6-8hours. Available as syrup 50mg/ml. Neonates: Oral - 2 mg/kg every 6 h, IV - 1.5 mg/kg every 6h. PAEDIATRICS: AZT has been approved (in a syrup formulation) for use in HIV+ children over three months old. The recommended dose of 90 mg/m2 is effective and less toxic than the previously recommended dose. SIDE EFFECTS: Reversible bone-marrow toxicity (anaemia or leukopenia), fatigue, rash, severe muscle pain and inflammation (myopathy), nausea, insomnia, and headache are associated with AZT therapy. Side effects are generally more severe and frequent with advanced disease. Enlarged fatty liver and lactic acidosis have been reported in patients taking nucleoside analogues, including AZT. Obese women and people with risk factors for liver disease be followed closely while receiving AZT. AZT IN PREGNANCY: AZT during labour and 48 hours after can reduce the chance of mother-to-baby transmission. RESISTANCE: There is considerable cross resistance among the nucleoside analogues. AZT resistant strains persist in the body long after the person has stopped taking the drug. AZT-resistant HIV-1 has been isolated from persons who have never received AZT, and the transmission of an AZT-resistant strain of HIV has been reported. INTERACTIONS: The combination of AZT and d4T is antagonistic reducing the drugs’ combined effects, and is not recommended. The risk of neutropenia is increased if AZT is taken with ganciclovir, doxorubicin, trimetrexate or co-trimoxazole. The risk of anaemia is increased if AZT is taken with pyrimethamine and sulphadiazine. (treatment for Toxo). AZT with interferon-alpha increases the risk of haematologic toxicities. Methadone increases AZT levels X 2, so the dose of AZT should be halved.
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