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RETROVIR

General description

Mechanism

Indications
    Retrovir is indicated for cases where antiretorviral therapy can be beneficial. This includes prevention of HIV transmission from mother to fetus and as part of combination treatment of adults with HIV disease.

Usage/Dosage
    For prevention of maternal-fetal HIV transmission, Retrovir should be taken orally by the mother beginning between 14 to 34 weeks of gestation, adminstered via IV during labor, and given to the neonate after birth in syrup form. For adults, the following dosage regimen can be followed:

    Disease stage Retrovir Daily Dosage (mg)
    Asymptomatic
    ACTG 019

    500
    Early HIV disease
    (CD4 > 200 cells/cub. mm)
    ACTG 016


    1200
    Advanced HIV disease
    (CD4 > 200 cells/cub. mm)
    BW 02


    1500
    (CD4 < 200 cells/cub. mm)
    ACTG 002
    BW 02

    600
    1500

Precautions
    Retrovir may have association with causing hematologic toxicity. This includes granulocytopenia and severe anemia, especially in patients with advanced HIV disease. Long term use of Retrovir may also result in symptomatic myopathy. No long term effects have been causally proven, however.
    Retrovir is eliminated from the body primarily through renal clearance and liver metabolism. People with severe renal or liver impairment should take reduced dosage. It should also be note that Retrovir is not a cure for HIV. Patients being treated with Retrovir for HIV infection may continue to develop illnesses associated with HIV advancement, including opportunistic infections. Combination treatment with ganciclovir, interpheron-alpha,bone marrow suppressives, and cytotoxic agents can increase change of hemotoxicity of Retrovir.

Contraindications
    Retrovir is contraindicated for any patients with known allergies to any components of the drug. Warnings for other drugs should also be consulted before beginning any combination treatment program. Patients with bone marrow compromise have higher rates of anemia and neutropenia, so caution should be exercised.

Potential Adverse Effects
    The most common effects are headache, anesthenia, fever, nausea, GI pain, and skin rash. Lactic acidosis, pancreatitis, vasculitis, and sensitization reactions are all severe effects that have been reported, however. Adverse reactions tend to worsen as HIV disease progresses, so patients should be monitored.