Children

Zidovudine (AZT, Retrovir) is often prescribed to children and infants. It was licensed for use in a syrup formulation in HIV-infected children aged over three months in 1990. The recommended dose for children has been 360 to 480mg/m² per day, divided into three or four doses, with a maximum of 200mg per dose.1 Large volumes of the syrup are not well tolerated by older children .

In 2008, the US FDA approved new dosing guidelines that allow for twice or thrice daily dosing in children 6 weeks to 18 years. Dosage can be calculated by weight or by body surface area. The new label has recommendations for twice daily or three times daily dosing by weight or by body surface area. Capsules and tablets have also been approved for use in children who are able to swallow them.

The new guidelines advise that children 4kg to <9kg receive 24mg/kg daily, administered as 12mg twice daily or 8mg three times a day. Children from 9 to <30kg should receive 18mg daily (divided doses of 9 bid or 6 three times daily), and children 30kg or more should receive 600mg daily, dosed at 300mg twice a day or 200mg three times a day.

Alternatively, dosing for zidovudine can be based on body surface area (BSA) for each child. The recommended oral dose is 480mg/m2/day in divided doses (240mg/m2 twice daily or 160mg/m2 three times daily). In some cases the dose calculated by mg/kg will not be the same as that calculated by BSA.

Side-effects of zidovudine in children are similar to adults, with anaemia being the most common.2 3

Combivir is only approved for use in children over 12 years of age, while Trizivir is not approved for use in those younger than 18 years.

References

  1. Brady M et al. Randomized study of the tolerance and efficacy of high- versus low-dose zidovudine in human immunodeficiency virus-infected children with mild to moderate symptoms (AIDS Clinical Trials Group 128). J Infect Dis 173: 1097-1106, 1996
  2. McKinney RE et al. A multicenter trial of oral zidovudine in children with advanced human immunodeficiency virus disease. N Engl J Med 324: 1018-1025, 1991
  3. Pizzo PA et al. Effect of continuous intravenous infusion of zidovudine (AZT) in children with symptomatic HIV infection. N Engl J Med 319: 889-896, 1988
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.