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Last reviewed on RxList: 3/10/2017
Retrovir Side Effects Center

Last reviewed on RxList 01/24/2017

Retrovir (zidovudine) is an antiviral medication used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Retrovir is also given during pregnancy to prevent an HIV-infected woman from passing the virus to her baby. Retrovir is not a cure for HIV or AIDS. Retrovir is available in generic form. Common side effects of Retrovir include:

  • headache,
  • nausea,
  • vomiting,
  • constipation,
  • trouble sleeping (insomnia),
  • loss of appetite,
  • joint pain, and
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

Tell your doctor if you have any serious side effects of Retrovir including:

  • unexplained weight loss,
  • persistent muscle aches or weakness,
  • joint pain,
  • numbness or tingling of the hands/feet/arms/legs,
  • severe tiredness,
  • vision changes,
  • severe or persistent headaches,
  • signs of infection (such as fever, chills, trouble breathing, cough, non-healing skin sores),
  • signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), or
  • signs of a certain nerve problem known as Guillain-Barre Syndrome (such as difficulty breathing/swallowing/moving your eyes, drooping face, paralysis, slurred speech).

The recommended adult oral dose of Retrovir is 600 mg/day in divided doses in combination with other antiretroviral agents. The pediatric dose of Retrovir is based on the child's weight. Retrovir may interact with atovaquone, doxorubicin, fluconazole, ganciclovir, interferon-alfa, methadone, nelfinavir, phenytoin, probenecid, ribavirin, ritonavir, or stavudine. Tell your doctor all medications you use. During pregnancy, Retrovir should be used only when prescribed. However, HIV medicines are often given to pregnant women with HIV. Treatment decreases the risk of HIV transmission to the baby. This medication passes into breast milk. Because breast milk can transmit HIV, do not breastfeed.

Our Retrovir (zidovudine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Retrovir Consumer Information

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

This medication may cause lactic acidosis (a build-up of lactic acid in the body, which can be fatal). Lactic acidosis can start slowly and get worse over time. Get emergency medical help if you have even mild symptoms of lactic acidosis, such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Stop taking zidovudine and call your doctor at once if you have any of these other serious side effects:

  • severe muscle pain;
  • signs of a new infection such as fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • pale skin, feeling light-headed, rapid heart rate, trouble concentrating;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • increased sweating, tremors in your hands, anxiety, feeling irritable, sleep problems (insomnia);
  • diarrhea, unexplained weight loss, menstrual changes, impotence, loss of interest in sex;
  • swelling in your neck or throat (goiter);
  • problems with walking, breathing, speech, swallowing, or eye movement;
  • weakness or prickly feeling in your fingers or toes;
  • severe lower back pain, loss of bladder or bowel control;
  • liver problems--upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate; or
  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • sleep problems (insomnia);
  • mild nausea, constipation;
  • joint pain;
  • headache; or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Retrovir (Zidovudine)

Retrovir Professional Information


The following adverse reactions are discussed in greater detail in other sections of the labeling:

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.


The frequency and severity of adverse reactions associated with the use of RETROVIR are greater in patients with more advanced infection at the time of initiation of therapy.

Table 3 summarizes adverse reactions reported at a statistically significant greater incidence for subjects receiving oral RETROVIR in a monotherapy trial.

Table 3: Percentage (%) of Subjects with Adverse Reactions (Greater than or Equal to 5% Frequency) in Asymptomatic HIV-1 Infection (ACTG 019)

Adverse Reaction RETROVIR 500 mg/day
(n = 453)
(n = 428)
Body as a whole
  Asthenia 9%a 6%
  Headache 63% 53%
  Malaise 53% 45%
  Anorexia 20% 11%
  Constipation 6%a 4%
  Nausea 51% 30%
  Vomiting 17% 10%
a Not statistically significant versus placebo.

In addition to the adverse reactions listed in Table 3, adverse reactions observed at an incidence of greater than or equal to 5% in any treatment arm in clinical trials (NUCA3001, NUCA3002, NUCB3001, and NUCB3002) were abdominal cramps, abdominal pain, arthralgia, chills, dyspepsia, fatigue, insomnia, musculoskeletal pain, myalgia, and neuropathy. Additionally, in these trials hyperbilirubinemia was reported at an incidence of less than or equal to 0.8%.

Selected laboratory abnormalities observed during a clinical trial of monotherapy with oral RETROVIR are shown in Table 4.

Table 4: Frequencies of Selected (Grade 3/4) Laboratory Abnormalities in Subjects with Asymptomatic HIV-1 Infection (ACTG 019)

Test (Abnormal Level) RETROVIR 500 mg/day
(n = 453)
(n = 428)
Anemia (Hgb < 8 g/dL) 1% < 1%
Granulocytopenia ( < 750 cells/mm³ ) 2% 2%
Thrombocytopenia (platelets < 50,000/mm³) 0% < 1%
ALT ( > 5 x ULN) 3% 3%
AST ( > 5 x ULN) 1% 2%
ULN = Upper limit of normal.

The adverse reactions reported during IV administration of RETROVIR injection are similar to those reported with oral administration; neutropenia and anemia were reported most frequently. Long-term IV administration beyond 2 to 4 weeks has not been studied in adults and may enhance hematologic adverse reactions. Local reaction, pain, and slight irritation during IV administration occur infrequently.


The clinical adverse reactions reported among adult recipients of RETROVIR may also occur in pediatric patients.

Trial ACTG 300: Selected clinical adverse reactions and physical findings with a greater than or equal to 5% frequency during therapy with EPIVIR® (lamivudine) oral suspension 4 mg per kg twice daily plus RETROVIR 160 mg per m² 3 times daily compared with didanosine in therapy-naive (less than or equal to 56 days of antiretroviral therapy) pediatric subjects are listed in Table 5.

Table 5: Selected Clinical Adverse Reactions and Physical Findings (Greater than or Equal to 5% Frequency) in Pediatric Subjects in Trial ACTG 300

Adverse Reaction EPIVIR plus RETROVIR
(n = 236)
(n = 235)
Body as a whole
  Fever 25% 32%
  Hepatomegaly 11% 11%
  Nausea & vomiting 8% 7%
  Diarrhea 8% 6%
  Stomatitis 6% 12%
  Splenomegaly 5% 8%
  Cough 15% 18%
  Abnormal breath sounds/wheezing 7% 9%
Ear, Nose, and Throat
  Signs or symptoms of earsa 7% 6%
  Nasal discharge or congestion 8% 11%
  Skin rashes 12% 14%
  Lymphadenopathy 9% 11%
a Includes pain, discharge, erythema, or swelling of an ear.

Selected laboratory abnormalities experienced by therapy-naive (less than or equal to 56 days of antiretroviral therapy) pediatric subjects are listed in Table 6.

Table 6: Frequencies of Selected (Grade 3/4) Laboratory Abnormalities in Pediatric Subjects in Trial ACTG 300

Test (Abnormal Level) EPIVIR plus RETROVIR Didanosine
Neutropenia (ANC < 400 cells/mm³) 8% 3%
Anemia (Hgb < 7.0 g/dL) 4% 2%
Thrombocytopenia (platelets < 50,000/mm³) 1% 3%
ALT ( > 10 x ULN) 1% 3%
AST ( > 10 x ULN) 2% 4%
Lipase ( > 2.5 x ULN) 3% 3%
Total amylase ( > 2.5 x ULN) 3% 3%
ULN = Upper limit of normal.
ANC = Absolute neutrophil count.

Macrocytosis was reported in the majority of pediatric subjects receiving RETROVIR 180 mg per m² every 6 hours in open-label trials. Additionally, adverse reactions reported at an incidence of less than 6% in these trials were congestive heart failure, decreased reflexes, ECG abnormality, edema, hematuria, left ventricular dilation, nervousness/irritability, and weight loss.

Use For The Prevention Of Maternal-Fetal Transmission Of HIV-1

In a randomized, double-blind, placebo-controlled trial in HIV-1-infected women and their neonates conducted to determine the utility of RETROVIR for the prevention of maternal-fetal HIV-1 transmission, RETROVIR syrup at 2 mg per kg was administered every 6 hours for 6 weeks to neonates beginning within 12 hours following birth. The most commonly reported adverse reactions were anemia (hemoglobin less than 9.0 g per dL) and neutropenia (less than 1,000 cells per mm³). Anemia occurred in 22% of the neonates who received RETROVIR and in 12% of the neonates who received placebo. The mean difference in hemoglobin values was less than 1.0 g per dL for neonates receiving RETROVIR compared with neonates receiving placebo. No neonates with anemia required transfusion and all hemoglobin values spontaneously returned to normal within 6 weeks after completion of therapy with RETROVIR. Neutropenia in neonates was reported with similar frequency in the group that received RETROVIR (21%) and in the group that received placebo (27%). The long-term consequences of in utero and infant exposure to RETROVIR are unknown.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of RETROVIR. Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body as a Whole

Back pain, chest pain, flu-like syndrome, generalized pain, redistribution/accumulation of body fat [see WARNINGS AND PRECAUTIONS].


Cardiomyopathy, syncope.


Macular edema.


Constipation, dysphagia, flatulence, oral mucosa pigmentation, mouth ulcer.


Sensitization reactions including anaphylaxis and angioedema, vasculitis.


Aplastic anemia, hemolytic anemia, leukopenia, lymphadenopathy, pancytopenia with marrow hypoplasia, pure red cell aplasia.


Hepatitis, hepatomegaly with steatosis, jaundice, lactic acidosis, pancreatitis.


Increased CPK, increased LDH, muscle spasm, myopathy and myositis with pathological changes (similar to that produced by HIV-1 disease), rhabdomyolysis, tremor.


Anxiety, confusion, depression, dizziness, loss of mental acuity, mania, paresthesia, seizures, somnolence, vertigo.

Reproductive System and Breast



Dyspnea, rhinitis, sinusitis.

Skin and Subcutaneous Tissue

Changes in skin and nail pigmentation, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis, sweating, urticaria.

Special Senses

Amblyopia, hearing loss, photophobia, taste perversion.

Renal and Urinary

Urinary frequency, urinary hesitancy.

Read the entire FDA prescribing information for Retrovir (Zidovudine)

Related Resources for Retrovir

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