NRTI (antiretroviral)

Zidovudine

Brand names: Retrovir

Adult dose

Dose: 250–300mg BD (oral); 1–2mg/kg IV q4h (IV formulation)

Route: Oral / IV

Frequency: BD (oral)

Clinical pearls

Largely superseded by tenofovir-based regimens for treatment-naïve patients
Retained role in: PMTCT, IV use in acute HIV, some neonatal prophylaxis protocols
BHIVA guidelines for HIV management; specialist initiation

Contraindications

Abnormally low neutrophil count or haemoglobin
Neonates with hyperbilirubinaemia requiring treatment (IV)
Hypersensitivity

Side effects

Anaemia
Neutropaenia
Myopathy
Lactic acidosis / hepatic steatosis (class)
Nausea
Headache
Lipodystrophy

Interactions

Nephrotoxic/myelotoxic drugs
Ribavirin (antagonism — avoid)
Stavudine (antagonism — avoid)
Atovaquone (increased levels)

Monitoring

FBC (anaemia, neutropaenia)
LFTs
Viral load / CD4
Lactate if symptomatic

Reference: BNF; BHIVA guidelines; NICE CG185 (legacy); https://bnf.nice.org.uk/drugs/zidovudine/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

HIV CD4/Viral Load Monitoring Intervals · HIV Management

Drugs

Emtricitabine · NRTI (antiretroviral)

Pathways