Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
AZT, Retrovir
Original Date: 
June 1996
Revised Date: 
November 2020
  • To reduce the risk of transmission of the HIV virus from an HIV positive mother to her baby. Administration to the baby is part of a defined protocol in which the mother has received antenatal combination antiretroviral therapy.
  • PO
  • IV intermittent infusion: over 30 minutes
Gestational Age (GA) Dose Duration
> 35 weeks PO: 4 mg/kg/dose q12h 4 - 6 weeks
IV: 3 mg/kg/dose q12h
> 30 to < 35 weeks PO: 2 mg/kg/dose q12h 2 weeks
IV: 1.5 mg/kg/dose q12h
Followed by:

PO: 3 mg/kg/dose q12h

4 weeks


IV: 2.3 mg/kg/dose q12h
< 30 weeks PO:2 mg/kg/dose q12h 4 weeks

IV: 1.5 mg/kg/dose q12h


Followed by:

PO: 3 mg/kg/dose q12h

2 weeks
IV: 2.3 mg/kg/dose q12h

 *** Zidovudine should be started as soon as possible after birth and no later than 2-6 hours after delivery.  Continue for 4 - 6 weeks

Side Effects: 
  • Endocrine and metabolic: lactic acidosis
  • Hematologic: anemia, neutropenia, thrombocytopenia, leukopenia
  • Hepatic: cholestatic hepatitis, hepatomegaly, elevated AST, LDH and ALP
Parameters to Monitor: 
  • CBC and differential (hemoglobin, absolute neutrophil count)
  • Liver transaminases (ALT, AST)
  • Lactic acid.
Reconstitution and Stability: 

IV intermittent infusion:

  • Zidovudine 10 mg/mL
    • Add 5 mL (50 mg) to 45 mL D5W
    • Final concentration: 1 mg/mL

- Solutions Compatible: D5W and 0.9 % NaCl

- Y-site Compatible: acyclovir, dobutamine, dopamine, gentamicin, morphine, potassium chloride, SMOF, TPN, vancomycin


- Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV. Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. versio Date: April 14, 2020. Available at

- Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States. Version Date: April 14, 2020 (Table 7).  Available at

-  Guidelines for the Prevention of Mother-to-Child HIV Transmission.  Information and Practice Guidance for Health Practitioners in Ontario.  Working with HIV-infected Women with Inadequate Control of HIV, and Women with Unknown HIV Status Who Present in Labor. Version Date: January 20, 2017

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