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Retrovir

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Retrovir

Retrovir

INDICATIONS

Treatment of HIV-1

RETROVIR, a nucleoside reverse transcriptase inhibitor, is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection.

Prevention of Maternal-Fetal HIV-1 Transmission

RETROVIR is indicated for the prevention of maternal-fetal HIV-1 transmission [see DOSAGE AND ADMINISTRATION]. The indication is based on a dosing regimen that included 3 components:

  1. antepartum therapy of HIV-1 infected mothers
  2. intrapartum therapy of HIV-1 infected mothers
  3. post-partum therapy of HIV-1 exposed neonate.

Points to consider prior to initiating RETROVIR in pregnant women for the prevention of maternal-fetal HIV-1 transmission include:

  • In most cases, RETROVIR for prevention of maternal-fetal HIV-1 transmission should be given in combination with other antiretroviral drugs.
  • Prevention of HIV-1 transmission in women who have received RETROVIR for a prolonged period before pregnancy has not been evaluated.
  • Because the fetus is most susceptible to the potential teratogenic effects of drugs during the first 10 weeks of gestation and the risks of therapy with RETROVIR during that period are not fully known, women in the first trimester of pregnancy who do not require immediate initiation of antiretroviral therapy for their own health may consider delaying use; this indication is based on use after 14 weeks gestation.

DOSAGE AND ADMINISTRATION

Treatment of HIV-1 Infection

Adults

The recommended oral dose of RETROVIR is 600 mg/day in divided doses in combination with other antiretroviral agents.

Pediatric Patients (Aged 4 Weeks to < 18 Years)

Healthcare professionals should pay special attention to accurate calculation of the dose of RETROVIR, transcription of the medication order, dispensing information, and dosing instructions to minimize risk for medication dosing errors.

Prescribers should calculate the appropriate dose of RETROVIR for each child based on body weight (kg) and should not exceed the recommended adult dose.

Before prescribing RETROVIR Capsules or Tablets, children should be assessed for the ability to swallow capsules or tablets. If a child is unable to reliably swallow a RETROVIR Capsule or Tablet, the RETROVIR Syrup formulation should be prescribed.

The recommended dosage in pediatric patients 4 weeks of age and older and weighing ≥4 kg is provided in Table 1. RETROVIR Syrup should be used to provide accurate dosage when whole tablets or capsules are not appropriate.

Table 1: Recommended Pediatric Dosage of RETROVIR

Body Weight (kg) Total Daily Dose Dosage Regimen and Dose
Twice Daily Three Times Daily
4 to < 9 24 mg/kg/day 12 mg/kg 8 mg/kg
≥ 9 to < 30 18 mg/kg/day 9 mg/kg 6 mg/kg
≥ 30 600 mg/day 300 mg 200 mg

Alternatively, dosing for RETROVIR can be based on body surface area (BSA) for each child. The recommended oral dose of RETROVIR is 480 mg/m²/day in divided doses (240 mg/m² twice daily or 160 mg/m² three times daily). In some cases the dose calculated by mg/kg will not be the same as that calculated by BSA.

Prevention of Maternal-Fetal HIV-1 Transmission

The recommended dosage regimen for administration to pregnant women (>14 weeks of pregnancy) and their neonates is:

Maternal Dosing

100 mg orally 5 times per day until the start of labor [see Clinical Studies]. During labor and delivery, intravenous RETROVIR should be administered at 2 mg/kg (total body weight) over 1 hour followed by a continuous intravenous infusion of 1 mg/kg/hour (total body weight) until clamping of the umbilical cord.

Neonatal Dosing

Start neonatal dosing within 12 hours after birth and continue through 6 weeks of age. Neonates unable to receive oral dosing may be administered RETROVIR intravenously. See Table 2.

Table 2: Recommended Neonatal Dosages of RETROVIR

Route Total Daily Dose Dose and Dosage Regimen
Oral 8 mg/kg/day 2 mg/kg every 6 hours
IV 6 mg/kg/day 1.5 mg/kg infused over 30 minutes, every 6 hours

Patients With Severe Anemia and/or Neutropenia

Significant anemia (hemoglobin < 7.5 g/dL or reduction >25% of baseline) and/or significant neutropenia (granulocyte count < 750 cells/mm or reduction >50% from baseline) may require a dose interruption until evidence of marrow recovery is observed [see WARNINGS AND PRECAUTIONS]. In patients who develop significant anemia, dose interruption does not necessarily eliminate the need for transfusion. If marrow recovery occurs following dose interruption, resumption in dose may be appropriate using adjunctive measures such as epoetin alfa at recommended doses, depending on hematologic indices such as serum erythropoetin level and patient tolerance.

Patients With Renal Impairment

End-Stage Renal Disease

In patients maintained on hemodialysis or peritoneal dialysis, the recommended dosage is 100 mg every 6 to 8 hours [see CLINICAL PHARMACOLOGY].

Patients With Hepatic Impairment

There are insufficient data to recommend dose adjustment of RETROVIR in patients with mild to moderate impaired hepatic function or liver cirrhosis.

HOW SUPPLIED

Dosage Forms And Strengths

RETROVIR Tablets 300 mg (biconvex, white, round, film-coated) containing 300 mg zidovudine, one side engraved “GX CW3” and “300” on the other side.

RETROVIR Capsules 100 mg (white, opaque cap and body) containing 100 mg zidovudine and printed with “Wellcome” and unicorn logo on cap and “Y9C” and “100” on body.

RETROVIR Syrup (colorless to pale yellow, strawberry-flavored) containing 10 mg zidovudine in each mL.

Storage And Handling

RETROVIR Tablets 300 mg (biconvex, white, round, film-coated) containing 300 mg zidovudine, one side engraved “GX CW3” and “300” on the other side.

Bottle of 60 (NDC 49702-214-18).

Store at 15° to 25°C (59° to 77°F).

RETROVIR Capsules 100 mg (white, opaque cap and body) containing 100 mg zidovudine and printed with “Wellcome” and unicorn logo on cap and “Y9C” and “100” on body.

Bottles of 100 (NDC 49702-211-20).

Store at 15° to 25°C (59° to 77°F) and protect from moisture.

RETROVIR Syrup (colorless to pale yellow, strawberry-flavored) containing 10 mg zidovudine in each mL.

Bottle of 240 mL (NDC 49702-212-48) with child-resistant cap.

Store at 15° to 25°C (59° to 77°F).

Manufactured for: ViiV Healthcare, Research Triangle Park, NC 27709. by: GlaxoSmithKline, Research Triangle Park, NC 27709. May 2012.

Last reviewed on RxList: 6/21/2012
This monograph has been modified to include the generic and brand name in many instances.

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