1 May 2026Oral drugsSource update: January 2025
Zidovudine = AZT = ZDV oral
Zidovudine guidance for HIV treatment and prevention of mother-to-child transmission, with haematologic precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Antiretroviral, nucleoside reverse transcriptase inhibitor.
Indications
- HIV infection, in combination with other antiretrovirals.
- Prevention of mother-to-child transmission of HIV in neonates, alone or in combination with other antiretrovirals.
Forms and strengths
- Single formulations: 300 mg tablet and 50 mg/5 ml oral solution.
- Fixed-dose combinations with lamivudine: 300 mg zidovudine/150 mg lamivudine breakable and dispersible tablet.
- 60 mg zidovudine/30 mg lamivudine breakable and dispersible tablet.
Dose
The daily dose is administered in 2 divided doses.
| Weight | Daily dose | 50 mg/5 ml oral sol. (10 mg/ml) | 300 mg tablet or 300 mg AZT/150 mg 3TC tablet | 60 mg AZT /30 mg 3TC tablet |
|---|---|---|---|---|
| 3 to < 6 kg | 120 mg | 6 ml x 2 | - | 1 tab x 2 |
| 6 to < 10 kg | 180 mg | 9 ml x 2 | - | 1 ½ tab x 2 |
| 10 to < 14 kg | 240 mg | 12 ml x 2 | - | 2 tab x 2 |
| 14 to < 20 kg | 300 mg | 15 ml x 2 | - | 2 ½ tab x 2 |
| 20 to < 25 kg | 360 mg | 18 ml x 2 | - | 3 tab x 2 |
| ≥ 25 kg | 600 mg | - | 1 tab x 2 | - |
HIV infection, in combination with other antiretrovirals
Child 1 month and over and adult.
- 3 to under 6 kg: 120 mg daily dose, corresponding to 6 ml 2 times daily or 1 tablet of 60 mg AZT/30 mg 3TC 2 times daily.
- 6 to under 10 kg: 180 mg daily dose, corresponding to 9 ml 2 times daily or 1 1/2 tablets of 60 mg AZT/30 mg 3TC 2 times daily.
- 10 to under 14 kg: 240 mg daily dose, corresponding to 12 ml 2 times daily or 2 tablets of 60 mg AZT/30 mg 3TC 2 times daily.
- 14 to under 20 kg: 300 mg daily dose, corresponding to 15 ml 2 times daily or 2 1/2 tablets of 60 mg AZT/30 mg 3TC 2 times daily.
- 20 to under 25 kg: 360 mg daily dose, corresponding to 18 ml 2 times daily or 3 tablets of 60 mg AZT/30 mg 3TC 2 times daily.
- 25 kg and over: 600 mg daily dose, corresponding to 1 tablet 2 times daily.
PMTCT of HIV in neonates
- Full term neonate: follow national recommendations. For information, WHO simplified age-based dosage: from birth to 6 weeks of age, 15 mg or 1.5 ml oral suspension 2 times daily.
- Then, if indicated, after 6 weeks and up to 12 weeks of age, 60 mg or 6 ml oral suspension 2 times daily.
- Preterm or low-birth weight neonate: seek specialist advice.
Duration
- HIV infection: depending on the efficacy and tolerance of AZT.
- PMTCT: depending on the risk of acquiring HIV infection.
- High risk: 6 weeks when AZT is combined with nevirapine. For breastfed children, this combined treatment may be extended for an additional 6 weeks.
- Low risk: 4 to 6 weeks with AZT alone, only for non-breastfed children.
Contra-indications, adverse effects, precautions
- Do not administer to patients with severe haematologic disorders such as anaemia or neutropenia.
- Administer with caution to patients with hepatic impairment, coinfection with hepatitis B or hepatitis C virus, and neonates with hyperbilirubinaemia or raised transaminases.
- Reduce dosage in patients with severe renal or hepatic impairment.
- May cause rash, gastrointestinal disturbances, myopathy, haematologic disorders, hepatic disorders, and lactic acidosis.
- Stop AZT in the event of severe anaemia or neutropenia; it may be resumed following recovery with reduced dosage and close surveillance.
- Stop AZT permanently if signs and symptoms of lactic acidosis are confirmed.
- Avoid combination with ribavirin because of the increased risk of anaemia.
- Use with caution and monitor combination with co-trimoxazole, dapsone, pyrimethamine, and fluconazole.
- Pregnancy: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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