Last update Dec. 21, 2022

Zidovudine (ZDV / AZT)

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Antiretroviral. It is a nucleoside reverse transcriptase inhibitor (NRTI), structurally related to thymidine, with anti-HIV activity. Oral administration in two daily doses. Intravenous presentation is also possible.

It is excreted in breastmilk in clinically insignificant amounts. (Ramírez 2018, Corbett 2014, Shapiro 2013 y 2005, Palombi 2012, Mirochnick 2009, Giuliano 2007)

Non-severe anemia and neutropenia may occur in the first months of life in infants whose mothers took it. (Dryden 2011, Bae 2008).

Except in one case (Shapiro 2005), the plasma levels of these infants were undetectable (Corbett 2014, Shapiro 2013, Palombi 2012, Mirochnick 2009) or very low. (Palombi 2012)

During breastfeeding, other HIV/AIDS treatments are preferable.(Panel 2022, WHO 2016)


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Zidovudine (ZDV / AZT) is also known as


Zidovudine (ZDV / AZT) in other languages or writings:

Group

Zidovudine (ZDV / AZT) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Zidovudine (ZDV / AZT) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 52 - 75 %
Molecular weight 267 daltons
Protein Binding 34 - 38 %
VD 1.6 ± 0.6 l/Kg
pKa 9.96 -
Tmax 1 - 1.5 hours
1.1 (0.5 - 2.9) hours
M/P ratio 0.7 - 3.2 -
Theoretical Dose 0.001 - 0.03 mg/Kg/d
Relative Dose 0.014 - 0.35 %

References

  1. Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States. Department of Health and Human Services. 2023 Consulted on June 16, 2023 Abstract Full text (link to original source)
  2. Ramírez-Ramírez A, Sánchez-Serrano E, Loaiza-Flores G, Plazola-Camacho N, Rodríguez-Delgado RG, Figueroa-Damián R, Domínguez-Castro M, López-Martínez M, Flores-García Z, Hernández-Pineda J. Simultaneous quantification of four antiretroviral drugs in breast milk samples from HIV-positive women by an ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method. PLoS One. 2018 Jan 19;13(1):e0191236. Abstract Full text (link to original source)
  3. WHO - World Health Organization Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Guideline. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. Pandhi D, Ailawadi P. Initiation of antiretroviral therapy. Indian J Sex Transm Dis. 2014 Abstract Full text (link to original source) Full text (in our servers)
  5. Corbett AH, Kayira D, White NR, Davis NL, Kourtis AP, Chasela C, Martinson F, Phiri G, Musisi B, Kamwendo D, Hudgens MG, Hosseinipour MC, Nelson JA, Ellington SR, Jamieson DJ, van der Horst C, Kashuba A; BAN Study Team.. Antiretroviral pharmacokinetics in mothers and breastfeeding infants from 6 to 24 weeks post-partum: results of the BAN Study. Antivir Ther. 2014;19(6):587-95. Abstract Full text (link to original source)
  6. Shapiro RL, Rossi S, Ogwu A, Moss M, Leidner J, Moffat C, Lockman S, Moyo S, Makhema J, Essex M, Capparelli E. Therapeutic levels of lopinavir in late pregnancy and abacavir passage into breast milk in the Mma Bana Study, Botswana. Antivir Ther. 2013;18(4):585-90. Abstract Full text (link to original source)
  7. Hirnschall G, Harries AD, Easterbrook PJ, Doherty MC, Ball A. The next generation of the World Health Organization's global antiretroviral guidance. J Int AIDS Soc. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. Palombi L, Pirillo MF, Andreotti M, Liotta G, Erba F, Sagno JB, Maulidi M, Ceffa S, Jere H, Marchei E, Pichini S, Galluzzo CM, Marazzi MC, Vella S, Giuliano M. Antiretroviral prophylaxis for breastfeeding transmission in Malawi: drug concentrations, virological efficacy and safety. Antivir Ther. 2012;17(8):1511-9. Abstract Full text (link to original source)
  9. Dryden-Peterson S, Shapiro RL, Hughes MD, Powis K, Ogwu A, Moffat C, Moyo S, Makhema J, Essex M, Lockman S. Increased risk of severe infant anemia after exposure to maternal HAART, Botswana. J Acquir Immune Defic Syndr. 2011 Apr 15;56(5):428-36. Abstract Full text (link to original source)
  10. Mirochnick M, Thomas T, Capparelli E, Zeh C, Holland D, Masaba R, Odhiambo P, Fowler MG, Weidle PJ, Thigpen MC. Antiretroviral concentrations in breast-feeding infants of mothers receiving highly active antiretroviral therapy. Antimicrob Agents Chemother. 2009 Mar;53(3):1170-6. Abstract Full text (link to original source)
  11. Rezk NL, White N, Bridges AS, Abdel-Megeed MF, Mohamed TM, Moselhy SS, Kashuba AD. Studies on antiretroviral drug concentrations in breast milk: validation of a liquid chromatography-tandem mass spectrometric method for the determination of 7 anti-human immunodeficiency virus medications. Ther Drug Monit. 2008 Oct;30(5):611-9. Abstract Full text (link to original source)
  12. Bae WH, Wester C, Smeaton LM, Shapiro RL, Lockman S, Onyait K, Thior I, Essex M. Hematologic and hepatic toxicities associated with antenatal and postnatal exposure to maternal highly active antiretroviral therapy among infants. AIDS. 2008 Aug 20;22(13):1633-40. Abstract Full text (link to original source)
  13. Giuliano M, Guidotti G, Andreotti M, Pirillo MF, Villani P, Liotta G, Marazzi MC, Mancini MG, Cusato M, Germano P, Loureiro S, Ceffa S, Regazzi M, Vella S, Palombi L. Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: a study within the Drug Resource Enhancement Against AIDS and Malnutrition Program. J Acquir Immune Defic Syndr. 2007 Mar 1;44(3):286-91. Abstract Full text (link to original source)
  14. Shapiro RL, Holland DT, Capparelli E, Lockman S, Thior I, Wester C, Stevens L, Peter T, Essex M, Connor JD, Mirochnick M. Antiretroviral concentrations in breast-feeding infants of women in Botswana receiving antiretroviral treatment. J Infect Dis. 2005 Sep 1;192(5):720-7. Epub 2005 Jul 27. Abstract Full text (link to original source)
  15. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)

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