HIV infection: 300mg q12h or 200mg q8h. Intravenous etc: DOSAGE AND ADMINISTRATION Adults
The recommended intravenous dose is 1 mg/kg infused over 1 hour. This dose
should be administered 5 to 6 times daily (5 to 6 mg/kg daily). The
effectiveness of this dose compared to higher dosing regimens in improving the
neurologic dysfunction associated with HIV disease is unknown. A small
randomized study found a greater effect of higher doses of RETROVIR on
improvement of neurological symptoms in patients with pre-existing neurological
disease.
Patients should receive RETROVIR IV Infusion only until oral therapy can be
administered. The intravenous dosing regimen equivalent to the oral
administration of 100 mg every 4 hours is approximately 1 mg/kg intravenously
every 4 hours.
Maternal-Fetal HIV Transmission
The recommended dosing 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. 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
2 mg/kg orally every 6 hours starting within 12 hours after birth and continuing
through 6 weeks of age. Neonates unable to receive oral dosing may be
administered RETROVIR intravenously at 1.5 mg/kg, infused over 30 minutes, every
6 hours.
Monitoring of Patients
Hematologic toxicities appear to be related to pretreatment bone marrow reserve
and to dose and duration of therapy. In patients with poor bone marrow reserve,
particularly in patients with advanced symptomatic HIV disease, frequent
monitoring of hematologic indices is recommended to detect serious anemia or
neutropenia (see WARNINGS). In patients who experience hematologic toxicity,
reduction in hemoglobin may occur as early as 2 to 4 weeks, and neutropenia
usually occurs after 6 to 8 weeks.
Dose Adjustment Anemia:
Significant anemia (hemoglobin of <7.5 g/dL or reduction of >25% of baseline)
and/or significant neutropenia (granulocyte count of<750 cells/mm3 or reduction
of >50% from baseline) may require a dose interruption until evidence of marrow
recovery is observed (see WARNINGS). 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.
For patients experiencing pronounced anemia while receiving chronic
coadministration of zidovudine and some of the drugs (e.g., fluconazole,
valproic acid) listed in Table 4, zidovudine dose reduction may be considered.
Renal Dosing
[CRCL> 10]: No changes
[CRCL < 10 – hemodialysis]: 100mg po q6-8h. Intravenous: End-Stage Renal Disease:
In patients maintained on hemodialysis or peritoneal dialysis (CrCl <15
mL/min), recommended dosing is 1 mg/kg every 6 to 8 hours
Hemodialysis
Hemo:
100mg po q6-8h.
Intravenous: End-Stage Renal Disease:
In patients maintained on hemodialysis or peritoneal dialysis (CrCl <15
mL/min), recommended dosing is 1 mg/kg every 6 to 8 hours
Disclaimer
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
judgment. Neither GlobalRPh Inc. nor any other party involved in the
preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER
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