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Lesson Special Issues for Children with HIV
en español

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NRTIs

Drug Use in Children Use in Newborns & Infants Pediatric Formulation
Emtriva
(emtricitabine)
The correct dose of Emtriva will depend on the child's weight. The usual dose—using a liquid solution of the drug—is 6 mg per kilogram of body weight, once a day (the dose should not exceed 240 mg per day). For older children weighing more than 73 pounds (33 kg) and are able to swallow pills, the adult dose of 200 mg once daily should be taken. Emtriva should not be used by infants younger than 3 months of age. For infants 3 months of age and older, the dose is 4 mg per kilogram of body weight, once a day. A liquid solution of Emtriva is available for babies and children, which is easier to give to young children than the adult capsules.
Epivir (lamivudine) The correct dose of Epivir will depend on the child's weight. The usual dose of the liquid formulation is 4 mg per kilogram of body weight, twice a day. A scored 150 mg tablet is also available. Dosing with the tablet depends on the weight of the child, and their ability to swallow pills. For children between 14 and 21 kilograms (31 and 47 pounds), a half tablet (75 mg) should be taken twice a day for a total daily dose of 150 mg. For children between 22 and 29 kilograms (48 and 65 pounds), a half tablet should be taken in the morning (75 mg) and a full tablet (150 mg) should be taken at night, for a total daily dose of 225 mg. Children 30 kilograms (66 pounds) and over should take a full tablet (150 mg) twice a day for a total daily dose of 300mg. Epivir can be used by newborns and infants younger than 30 days of age. The usual dose is 2 mg per kilogram of body weight, twice a day. A liquid solution of Epivir is available for babies and children. A lower dose tablet is available for children who can swallow pills.
Retrovir (zidovudine) The correct dose of Retrovir, or its generic counterpart (available in U.S. pharmacies), will depend on the size of the child. The recommended dose in children 4 weeks of age and older and weighing between 4 kg and 29.99 kg is calculated on body weight. For childen weighing between 4 kg and 8.99 kg the dose is 12 mg/kg twice-daily or 8 mg/kg three times a day. For children weighing between 9 kg and 29.99 kg the dose is 9 mg/kg twice-daily or 6 mg/kg three times a day. For children weighing 30 kg and more, the correct dose is not weight based. It is 300 mg twice-daily or 200 mg three times per day. Retrovir and generic zidovudine can be used by newborns and infants younger than 4 weeks of age, to either prevent transmission of the virus at the time of birth of as treatment for HIV infection. The correct dose will depend on the weight of the baby. The usual dose is 2 mg per kilogram of body weight, every 6 hours. Newborns and infants may also receive the drug intravenously, particularly if they are hospitalized. A dose is also available for babies born prematurely. A syrup formulation of Retrovir and generic zidovudine is available for babies and children, which is easier to give to young children than the adult capsules.
Videx (didanosine) The correct dose of Videx will depend on the size of the child. The usual dose—using a powder to be mixed with water—is 120 mg per square meter of body surface area, every 12 hours. HIV-positive children starting therapy for the first time may also be able to use the Videx powder solution once daily, at a dose of 240 mg per square meter of body surface area. The once-daily Videx EC capsules, or its generic counterpart (available in U.S. pharmacies), can be used by children 6 years of age and older, with the dose depending on their body weight (ranging from 200 to 400 mg a day). Videx can be used by infants between 2 weeks and 8 months of age. The correct dose will depend on the size of the child. The usual dose is 100 mg per square meter of body surface area, every 12 hours. A powder formulation of Videx and generic didanosine is available, which needs to be mixed with water and given to the child on an empty stomach, meaning no food or other medications taken at the same time as Videx. For older children, capsules and chewable tablets (which can also be dispersed in water) are available.
Viread (tenofovir DF) Not yet approved or studied in HIV-positive patients younger than 18 years of age. Pediatric formulations, using doses based on young children's body weight and older children's body surface area, are being studied. Not yet approved or studied in HIV-positive patients younger than 18 years of age. Not available.
Zerit (stavudine) The correct dose of Zerit, or its generic counterpart (available in U.S. pharmacies), will depend on the child's weight. The usual dose is 1 mg per kilogram of body weight, twice a day. Once the child reaches a weight of 30 kilograms (66 pounds), 30 mg capsules, given twice a day, should be given. And once the child reaches 60 kg (132 pounds), 40 mg capsules, given twice a day, should be prescribed. At birth, and until the infant is 13 days old, the dose should be 0.5 mg per kilogram of body weight, twice a day. Standard pediatric doses should be followed for children 14 days of age and older. A liquid solution of Zerit and generic stavudine is available for babies and children, which is easier to give to young children than the adult capsules.
Ziagen (abacavir) The correct dose of Ziagen will depend on the child's weight. The usual dose is 8 mg per kilogram of body weight, twice a day. No more than 300 mg of Ziagen, twice daily, should be given. Thus, when the child weighs 38 kg (83.6 pounds) or more, the adult tablets can be used. All children should be tested for an gene, called HLA-B*5701, before starting Ziagen. This inherited gene is associated with an increased risk of a serious allergic reaction to Ziagen; if it is found using the inexpensive test, Ziagen should not be started. Ziagen is not yet approved for newborns and infants younger than three months of age. A liquid solution of Ziagen is available for babies and children. The makers of Ziagen have also developed a scored tablet that can be easily divided for children who can swallow pills.

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Last Revised: November 19, 2009

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