Zidovudine adverse effects

The increase in zidovudine levels with methadone is established, although the clinical relevance is uncertain. Be alert for any increase in zidovudine adverse effects. The balance of evidence suggests that zidovudine is unlikely to reduce methadone levels, and the one case reported remains unexplained, although note that some of the adverse effects of zidovudine may be mistaken for opioid withdrawal effects. 

The answer is e. (Hardman, p 1206. Katzang, p 833J A major adverse effect of zidovudine is bone marrow depression that appears to be dose-and duration-dependent. The severity of the disease and a low CD4 count contribute to the bone marrow depression. 

Fixed-dose combination Lamivudine/zidovudine tablets are a fixed-dose combination doseform that does not allow for dose reduction. Avoid use in patients requiring lamivudine or zidovudine dosage reduction including children under 12 years of age, renally impaired patients with Ccr less than 50 mL/min, or those experiencing dose-limiting adverse effects. 

The adverse effects with which stavudine is most frequently associated are headache, diarrhea, skin rash, nausea, vomiting, insomnia, anorexia, myalgia, and weakness. Peripheral neuropathy consisting of numbness, tingling, or pain in the hands or feet is also common with higher doses of the drug. Significant elevation of hepatic enzymes may be seen in approximately 10 to 15% of patients. Lactic acidosis occurs more frequently with stavudine than with other NRTIs. Viral resistance to stavudine may develop, and cross-resistance to zidovudine and didanosine may occur. 

The most common adverse effect produced by didanosine is diarrhea. Abdominal pain, nausea, vomiting, anorexia, and dose-related peripheral neuropathy may occur. Pancreatitis occurs rarely, as do hyperuricemia, bone marrow suppression, retinal depigmentation, and optical neuritis. Resistance to didanosine appears to result from mutations different from those responsible for zidovudine resistance. 

Lamivudine is the best-tolerated NRTI. Its most common adverse effects include headache, malaise, fatigue, and insomnia. Pancreatitis is rare. Gastrointestinal complaints are common with lamivudine-zidovudine therapy but are probably mainly due to the zidovudine component. Lamivudine resistance sometimes occurs early in treatment. Cross-resistance to zal-citabine, didanosine, and abacavir can occur simultaneously. Withdrawal of lamivudine in patients infected with both hepatitis B virus and HIV can cause a flare-up of hepatitis symptoms. 

Lipodystrophy is a common adverse effect of antiretroviral drugs, particularly the NRTIs and has been reported with zidovudine (1209). 

The most common adverse effect of zidovudine is myelosuppression, resulting in anemia or... 

Indinavir sulfate is a protease inhibitor and is used in combinations for the treatment of viral infection. During the high risk of HIV infection, indinavir is combined with zidovudine and lamivudine.65 Indinavir sulfate should be used with caution in patients with hepatic impairment and avoided in patients with severe liver damage. Caution is needed in diabetic patients and in patients with hemophilia. Adverse effects of indinavir sulfate include nausea, vomiting, diarrhea, fatigue, dizziness, headache, skin rashes, and allergic reactions (hematuria). 

Adverse effects Adverse effects include severe, dose-dependent neutropenia. [Note Combined treatment with zidovudine can result in additive neutropenia.] Ganciclovir is carcinogenic as well as embryotoxic and teratogenic in experimental animals. 

D Cruz, O. I, and Uckun, F. M. (2001), Lack of adverse effects on fertility of female CD-I mice exposed to repetitive intravaginal gel-microemulsion formulation of a dualfunction anti-HIV agent Aryl phosphate derivative of bromo-methoxy-zidovudine (compound WHI-07), J. Appl. Toxicol., 21,317-322. 

PHENYTOIN NUCLEOSIDE REVERSE TRANSCRIPASE INHIBITORS - DIDANOSINE, STAVUDINE, ZIDOVUDINE Possibly t adverse effects (e.g. peripheral neuropathy) with didanosine, stavudine and zidovudine Additive effect Monitor closely for peripheral neuropathy during prolonged combination... 

BZDs NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS-ZIDOVUDINE t adverse effects including t incidence of headaches when oxazepam is co administered with zidovudine Uncertain Monitor closely... 

DOXORUBICIN ANTIVIRALS-ZIDOVUDINE t adverse effects when doxorubicin is co administered with zidovudine Additive toxicity Monitor FBC and renal function closely. 1 doses as necessary... 

HYDROXYCARBAMIDE ANTIVIRALS -DIDANOSINE, ZIDOVUDINE t adverse effects with didanosine and possibly zidovudine Additive effects, enhanced antiretroviral activity via 1 intracellular deoxynudeotides Avoid co-administration... 

CHLORAMPHENICOL ANTIVIRALS-ST AVUDINE, ZIDOVUDINE Possible t adverse effects when coadministered with stavudine or zidovudine Uncertain Use an alternative antibiotic if possible otherwise monitor closely for peripheral neuropathy and check FBC regularly... 

DAPSONE ANTIVIRALS-ZIDOVUDINE Possible t adverse effects when co administered with zidovudine Uncertain possible T bioavailability of zidovudine Use with caution monitor for peripheral neuropathy... 

---