Retrovir


Also found in: Dictionary, Thesaurus, Encyclopedia, Wikipedia.
Related to Retrovir: retrovirus, AZT, zidovudine

Retrovir

 [ret´ro-vir]
trademark for preparations of zidovudine, an antiretroviral active against the human immunodeficiency virus.

zidovudine

Apo-Zidovudine (CA), Novo-AZT (CA), Retrovir

Pharmacologic class: Nucleoside reverse transcriptase inhibitor

Therapeutic class: Antiretroviral

Pregnancy risk category C

FDA Box Warning

• Drug has been linked to hematologic toxicity (including neutropenia and severe anemia), particularly in patients with advanced human immunodeficiency virus (HIV) infection.

• Prolonged use is associated with symptomatic myopathy.

• Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have occurred with use of nucleoside analogs alone or in combination, including zidovudine and other antiretrovirals.

Action

After conversion to its active metabolite, inhibits activity of HIV reverse transcriptase and terminates viral DNA growth

Availability

Capsules: 100 mg

Injection: 10 mg/ml in 20-ml vial

Syrup: 50 mg/5 ml

Tablets: 300 mg

Indications and dosages

HIV-1 infection

Adults and children older than age 12: 600 mg P.O. total daily dosage divided into either b.i.d. or t.i.d. dosing; or 1 mg/kg I.V. five to six times daily; in combination with other antiretrovirals

Children ages 4 weeks to younger than 18 years weighing 30 kg (66 lb) or more: 600 mg P.O. total daily dosage divided into either b.i.d. or t.i.d. dosing; or 480 mg/m2 total daily dosage divided into either b.i.d. or t.i.d. dosing. Don't exceed recommended adult dosage.

Children ages 4 weeks to younger than 18 years weighing 9 kg (20 lb) to less than 30 kg (66 lb): 18 mg/kg/day total daily dosage divided into either b.i.d. or t.i.d. dosing; or 480 mg/m2 total daily dosage divided into either b.i.d. or t.i.d. dosing. Don't exceed recommended adult dosage.

Children ages 4 weeks to younger than 18 years weighing 4 kg (9 lb) to less than 9 kg (20 lb): 24 mg/kg/day total daily dosage divided into either b.i.d. or t.i.d. dosing; or 480 mg/m2 total daily dosage divided into either b.i.d. or t.i.d. dosing. Don't exceed recommended adult dosage.

To prevent maternal-fetal HIV transmission

Pregnant women (more than 14 weeks of pregnancy): 500 mg P.O. daily in divided doses (usually as five 100-mg doses) until labor begins; then 2 mg/kg I.V. over 1 hour followed by a continuous infusion of 1 mg/kg/hour until umbilical cord is clamped

Neonates: 2 mg/kg P.O. q 6 hours starting within 12 hours of delivery and continuing for 6 weeks. For neonates unable to receive oral dosing, 1.5 mg/kg by I.V. infusion over 30 minutes q 6 hours

Dosage adjustment

• End-stage renal disease in patients maintained on hemodialysis or peritoneal dialysis

• Hematologic toxicity

• Concurrent use of drugs (such as fluconazole or valproic acid) in patients experiencing pronounced anemia

Off-label uses

• Occupational exposure to HIV

Contraindications

• Patients who have had potentially life-threatening allergic reactions (such as anaphylaxis, Stevens-Johnson syndrome) to drug or its components

Precautions

Use cautiously in:

• renal or hepatic impairment, known risk factors for liver disease, decreased bone marrow reserve, hemoglobin less than 9.5 g/dl, granulocyte count less than 1,000 cells/mm3

• concurrent use of Combivir or Trizivir (zidovudine-containing products) or interferon- and ribavirin-based regimens

• pregnant or breastfeeding patients.

Administration

For I.V. use, remove dose from vial and add to I.V. solution containing dextrose 5% in water, to yield a final concentration no higher than 4 mg/ml. Infuse over 1 hour. Avoid rapid infusion or bolus injection. Don't give by I.M. route.

• In adults, give by I.V. route only until patient can tolerate oral dose.

• If a child is unable to reliably swallow a capsule or tablet, give syrup formulation.

Adverse reactions

CNS: headache, paresthesia, malaise, insomnia, dizziness, drowsiness, asthenia, seizures

GI: nausea, vomiting, constipation, abdominal pain, dyspepsia, anorexia, pancreatitis

Hematologic: severe anemia (necessitating transfusions), agranulocytopenia, severe bone marrow depression

Hepatic: severe hepatomegaly with steatosis

Metabolic: lactic acidosis

Musculoskeletal: myalgia, back pain, myopathy

Respiratory: dyspnea

Skin: diaphoresis, rash, altered nail pigmentation

Other: abnormal taste, fever, immune reconstitution syndrome

Interactions

Drug-drug. Acetaminophen, aspirin, indomethacin: increased risk of zidovudine toxicity

Amphotericin B, dapsone, flucytosine, pentamidine: increased risk of nephrotoxicity and bone marrow depression

Cyclosporine: extreme drowsiness, lethargy

Cytotoxic drugs, myelosuppressants, nephrotoxic drugs (such as ganciclovir, interferon alfa): increased risk of hematologic toxicity

Fluconazole, methadone, probenecid, valproic acid: increased zidovudine blood level, greater risk of toxicity

Ribavirin: antagonism of zidovudine's antiviral activity

Drug-diagnostic tests. Granulocytes, hemoglobin, platelets: decreased levels

Drug-herbs. St. John's wort: decreased zidovudine efficacy

Patient monitoring

• Monitor neurologic status, especially for signs and symptoms of impending seizure.

Periodically assess CBC and kidney and liver function tests. Be aware that drug can cause hepatotoxicity.

Watch for signs and symptoms of pancreatitis, immune reconstitution syndrome, and lactic acidosis.

Patient teaching

• Tell patient he may take with or without food.

• Instruct patient to take capsules with at least 4 oz of fluid and to stay upright after taking.

• Explain therapy to patient. Emphasize that drug doesn't cure HIV infection.

• Urge patient to take drug exactly as prescribed.

Teach patient to recognize and immediately report signs and symptoms of serious side effects, such as seizures.

• Stress importance of follow-up laboratory testing.

• Advise female of childbearing age to use effective contraception.

• Inform pregnant patient that drug reduces risk of, but may not prevent, HIV transmission to neonate.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

Retrovir

(rĕt′rō-vîr)
A trademark for the drug AZT (zidovudine).

AZT

A nucleoside analogue used with other anti-HIV agents to manage AIDS and HIV infection.
 
Adverse effects
Long-term AZT use is associated with muscle loss, nausea, anaemia, myelosuppression, oral ulcers, bone marrow damage and headache.

Retrovir®

Zidovudine, see there.

Retrovir

An antiviral drug with some useful effect against the RETROVIRUS HIV that causes AIDS. Also known as AZT (azidothymidine) and ZIDOVUDINE.
References in periodicals archive ?
children/adolescents with HIV Combination ART use -50% Hivid use +80% Retrovir use +90% Figure 1.
Conf Retrovir Oppor Infect 2002 Washington Feb 24-28; 9: abstract no.
Currently available anti-HIV drugs Protease Inhibitors Nucleotide Reverse Agenerase (generic name: amprenavir) Transcriptase Inhibitor Crixivan (indinavir) Viread (tenofovir, PMPA) Fortovase (saquinavir) Kaletra (lopinavir plus ritonavir) Nucleoside Reverse Norvir (ritonavir) Transcriptase Inhibitors Viracept (nelfinavir) Combivir (AZT plus 3TC) Epivir (lamivudine, also Nonnucleoside Reverse known as 3TC) Transcriptase Inhibitors Hivid (zalcitabine, ddC) Rescriptor (delavirdine) Retrovir (zidovudine, AZT) Sustiva (efavirenz) Trizivir (abacavir plus AZT plus 3TC) Viramune (nevirapine) Videx (didanosine, ddl) Zerit (stavudine, d4T) Ziagen (abacavir)
John was taking Retrovir, a drug prescribed only for patients with AIDS.
The investigation showed that Doe had been getting prescriptions for Retrovir, an anti-AIDS drug.
Preliminary results of a international trial of Retrovir (zidovudine, also known as AZT) indicate that treatment with the drug can reduce by two-thirds the risk of HIV-infected pregnant women transmitting the virus to their babies.
Department of Health and Human Services, described a recent nationwide study that found that the antiviral drug zidovudine (trademark Retrovir, commonly known as AZT) may delay the progression to AIDS in symptomless infected individuals.
Retrovir (AZT) and aerosol pentamidine, the two most widely prescribed medications, cost about $8,000 and $1,200 respectively for a year's supply.
A videocassette describing the use of Retrovir (AZT), the only anti-AIDS drug approved by the FDA, was sent unsolicited to thousands of physicians across the nation.
Azidothymidine (AZT)--made under the brand name Retrovir by the Burroughs Wellcome Co.
AIDS Res Hum Retrovir. 2016, http://dx.doi.org/10.1089/AID.2016.0159.