Adults: 60kg: 40mg q12h. <60kg: 30mg q12h. Renal Impairment: CrCl 26-50mL/min: 60kg: 20mg q12h. <60kg: 15mg q12h. CrCl 10-25mL/min or on Hemodialysis: 60kg: 20mg q24h. <60kg: 15mg q24h. Give after the completion of hemodialysis on dialysis days and at the same time of day on non-dialysis days.
Pediatrics: 60kg: 40mg q12h. 30-<60kg: 30mg q12h. 14 Days Old and <30kg: 1mg/kg q12h. Birth13 Days Old: 0.5mg/kg q12h.
Category C, not for use in nursing.
Synthetic thymidine nucleoside analogue; inhibits activity of HIV-1 reverse transcriptase by competing with natural substrate thymidine triphosphate and by causing DNA chain termination following its incorporation into viral DNA. Inhibits cellular DNA polymerases and gamma and markedly reduces synthesis of mitochondrial DNA.
Absorption: Rapid. Oral bioavailability (86.4%) (adults), (76.9%) (pediatric patients); C
Assess for drug hypersensitivity, risk factors for lactic acidosis or liver disease, renal/hepatic impairment, history of peripheral neuropathy, pregnancy/nursing status, and possible drug interactions.
Monitor for signs/symptoms of lactic acidosis, hepatotoxicity, worsening of liver disease, motor weakness, peripheral neuropathy, pancreatitis, fat redistribution/accumulation, lipoatrophy/lipodystrophy, immune reconstitution syndrome (eg, opportunistic infections), and autoimmune disorders.
Inform that therapy is not a cure for HIV and patients may continue to experience illnesses associated with HIV. Advise to avoid doing things that can spread HIV to others (eg, sharing needles, other inj equipment, or personal items that can have blood or body fluids on them; sex without protection; breastfeeding). Advise diabetic patients that oral sol contains 50mg of sucrose/mL. Advise to seek medical attention immediately if symptoms of hyperlactatemia or lactic acidosis syndrome (eg, unexplained weight loss, abdominal discomfort, N/V, fatigue, dyspnea, motor weakness) develop. Instruct to report symptoms of peripheral neuropathy (eg, numbness, tingling, or pain in the hands or feet) to physician. Advise to avoid alcohol while on therapy. Inform that fat redistribution/accumulation may occur.
Clinical Pearl is a Continuous professional development platform with a precise and concise point of care clinical knowledge search engine and 360-degree learning cycle management platform for all healthcare professionals and organizations.