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Answers from Dr. Kaiser Question: I know that the way AZT is dosed has been changed but wonder if the toxicity still holds true? Do you put any of your patients on AZT?Dr. Kaiser replies: When AZT first came out in the early 1990's, patients were told to set their alarm clocks to take their medication every four hours straight through the night for months at a time. All the while this medication was being taken at twice the current dosage and causing patients to experience terrible side effects, especially anemia and low white blood cell counts.While AZT is now known to be an effective antiviral at half the original dosage taken only twice daily, the terrible memories of the suffering it caused many friends and loved ones still persist. Since AZT is the only antiviral with bone marrow suppression as its primary side effect, and since the bone marrow is what produces your red and white blood cells including CD4 cells, I prefer to hold AZT in reserve and not use it as first line antiviral therapy. There are many other, better tolerated antiviral medications to choose from for your initial therapy including D4T, DDI, and abacavir. AZT can be used later on if necessary. |
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