It is considered appropriate to use zidovudine (AZT) in the following conditions:
1. Management of diagnosed cases of human immunodeficiency virus infections.
2. Treatment of advanced AIDS-related complex in patients with a history of Pneumocystic carinii pneumonia
and/or
a T-cell count from peripheral blood of less than 200/mm3.
3. Acute occupational exposure of hospital personnel. This requires informed consent, documentation in the patient’s medical record and referral to Student Employee Health for follow-up.
Dose:
When T-4 counts are 200 - 500
<55 kg — 200 mg qid x 1 month; then 200 mg at breakfast and lunch with 100 mg at bedtime (500 mg/day)
>55 kg — 200 mg q 4 hr. x 1 month, then 200 mg at breakfast and lunch with 100 mg at bedtime (500 mg/day)
When T-24 counts are less than 200, (depending on ability to tolerate)
<55 kg — 200 mg qid x 1 month, then 200 mg q 8 hr.
>55 kg — 200 mg q 4 hr. x 1 month, then 200 mg q 8 hr.
For occupational exposure —
200 mg every 4 hours while awake (1000 mg/day) for 28 days beginning preferably within 2 hours of exposure.
Monitor:
1. Anemia — are blood products or erythropoetin used?
2. Leukopenia — Neutrophils < 1000 alter dose
Leukopenia — Neutrophils < 500 — stop drug
3. Use of following drugs with Zidovudine
a. Acetaminophen
b. NSAID
c. Ganciclovir
d. Any drug metabolized by hepatic glucouronidation
e. Ribavirin — antagonizes AZT
