Retrovir: Advanced Antiretroviral Therapy for HIV Management
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Retrovir (zidovudine) is a nucleoside reverse transcriptase inhibitor (NRTI) indicated for the treatment of human immunodeficiency virus (HIV-1) infection. As one of the foundational antiretroviral agents, it has been extensively studied and remains a critical component in combination therapy regimens. This medication works by inhibiting the reverse transcriptase enzyme, thereby impeding viral replication and reducing viral load. Retrovir is utilized in both treatment-naïve and experienced patients, often forming the backbone of highly active antiretroviral therapy (HAART). Proper adherence to prescribed regimens is essential for optimizing therapeutic outcomes and minimizing resistance development.
Features
- Contains zidovudine 300 mg as the active pharmaceutical ingredient
- Available in tablet and oral solution formulations for flexible dosing
- Demonstrated efficacy in reducing maternal-fetal HIV transmission
- Compatible with most combination antiretroviral regimens
- Manufactured under strict quality control standards
- Includes child-resistant packaging for safety
Benefits
- Significantly reduces HIV viral load when used in combination therapy
- Helps restore and preserve immune function by increasing CD4 cell counts
- Demonstrated efficacy in preventing perinatal HIV transmission
- Established long-term safety profile with decades of clinical use
- Contributes to improved quality of life and life expectancy
- Available through multiple access programs for eligible patients
Common use
Retrovir is primarily indicated for the treatment of HIV-1 infection in adults and children, always in combination with other antiretroviral agents. It is also approved for the prevention of maternal-fetal HIV transmission during pregnancy, labor, and delivery, as well as for prophylaxis in newborns exposed to HIV. The medication may be used as part of post-exposure prophylaxis (PEP) regimens following occupational or non-occupational exposure to HIV. Clinical decisions regarding its use should be based on current treatment guidelines, resistance testing, and individual patient factors including comorbidities and concomitant medications.
Dosage and direction
Adults: 300 mg twice daily or 200 mg three times daily with or without food Pediatric patients: 160 mg/m²/dose three times daily (not to exceed 200 mg per dose) Prevention of maternal-fetal transmission: Specific dosing regimen during pregnancy and intrapartum period Neonatal prophylaxis: 2 mg/kg/dose every 6 hours beginning within 6-12 hours after birth and continuing through 6 weeks of age
Dosage adjustments are required for patients with impaired renal function (creatinine clearance <50 mL/min) or significant hepatic impairment. Tablets should be swallowed whole with water; the oral solution should be measured using the provided dosing syringe. Consistency in administration timing is crucial for maintaining therapeutic drug levels.
Precautions
Complete blood counts should be monitored frequently, especially during the first three months of therapy, due to risk of hematologic toxicity. Patients with pre-existing bone marrow compromise or those receiving concomitant myelosuppressive medications require particularly close monitoring. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with nucleoside analogues. Patients should be monitored for signs and symptoms of these conditions. Fat redistribution and accumulation have been observed with antiretroviral therapy. Regular monitoring of liver function, renal function, and serum lipids is recommended during treatment.
Contraindications
Retrovir is contraindicated in patients with known hypersensitivity to zidovudine or any component of the formulation. It should not be administered to patients with potentially life-threatening allergic reactions to any of the ingredients. Concomitant use with stavudine is contraindicated due to antagonistic effects. Use with ribavirin or other drugs that may cause lactic acidosis or hepatic toxicity requires careful risk-benefit assessment. The medication is not recommended for patients with severe hepatic impairment without dosage adjustment and close monitoring.
Possible side effect
Common (≥10%): Headache, nausea, vomiting, diarrhea, insomnia, asthenia Less common (1-10%): Anorexia, dizziness, myalgia, rash, fever, chills Serious: Severe bone marrow suppression (anemia, neutropenia, thrombocytopenia), lactic acidosis, hepatic steatosis, myopathy, lipodystrophy, hypersensitivity reactions Laboratory abnormalities: Elevated liver enzymes, hyperbilirubinemia, elevated amylase, macrocytosis
Patients should be advised to report any signs of infection, unusual bleeding or bruising, muscle pain or weakness, or symptoms of lactic acidosis (nausea, vomiting, abdominal pain) promptly to their healthcare provider.
Drug interaction
Significant interactions: Concomitant use with other myelosuppressive agents (ganciclovir, interferon-alpha, pyrimethamine) may increase hematologic toxicity. Combination with nephrotoxic drugs may affect elimination. Probenecid may decrease zidovudine clearance. Phenytoin levels may be altered when co-administered with Retrovir. Moderate interactions: Clarithromycin may decrease zidovudine concentrations. Concomitant use with other NRTIs requires careful consideration of overlapping toxicities. Theoretical interactions: Drugs that undergo glucuronidation may compete with zidovudine metabolism.
A comprehensive medication review should be conducted before initiating therapy and periodically during treatment.
Missed dose
If a dose is missed, it should be taken as soon as possible unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed dose. Consistency in dosing is critical for maintaining virologic suppression and preventing resistance development. Healthcare providers should discuss strategies for improving adherence if doses are frequently missed.
Overdose
Symptoms of overdose may include nausea, vomiting, lethargy, and hematologic toxicity. Hemodialysis and peritoneal dialysis have been shown to enhance zidovudine elimination. Management should include supportive care with monitoring of hematologic parameters and vital signs. There is no specific antidote for zidovudine overdose. In cases of suspected overdose, medical attention should be sought immediately, and the poison control center should be contacted for latest management recommendations.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Keep the container tightly closed and protect from excessive moisture and light. Do not freeze the oral solution. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Proper disposal of unused medication should follow local regulations or through take-back programs to prevent environmental contamination and accidental exposure.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with a qualified healthcare professional familiar with the patient’s complete medical history. The prescribing physician should be consulted for specific dosing recommendations and management of adverse effects. This document does not replace the official prescribing information and should be used in conjunction with current treatment guidelines.
Reviews
“Retrovir has been a cornerstone of HIV therapy for decades. Its well-characterized safety profile and efficacy in combination regimens make it a valuable option, particularly in resource-limited settings where newer agents may not be available.” - Infectious Disease Specialist, 15 years experience
“While newer agents offer advantages in terms of side effect profiles, zidovudine remains an important component in certain clinical scenarios, particularly in prevention of mother-to-child transmission. Its long-term data provide confidence in its use.” - HIV Clinical Pharmacist
“Patient tolerance has improved with the twice-daily formulation, though hematologic monitoring remains essential. In properly selected patients, it continues to provide excellent virologic control.” - Clinical Researcher, HIV Therapeutics