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Pediatric Dosing Schedule

Winter 1999

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

Nucleoside Reverse Transcriptase Inhibitors (nRTIs)
Drug NameHow SuppliedRecommended DoseSpecial Considerations
Epivir
lamivudine
3TC (approved for pediatrics)
  • Solution: 10 mg per ml.

  • Tablets: 150 mg.
  • Infants less than 30 days: 2 mg per kg twice daily.

  • Pediatric dose: 4 mg per kg twice daily.
Can be given with or without food. Keep solution at room temperature. Dose may need to be decreased if there are kidney problems.
HIVID
zalcitabine
ddC (not approved for pediatrics)
  • Syrup is experimental: 0.1 mg per ml.

  • Tablets: 0.375 mg or 0.75 mg.
  • Experimental only: 0.005 to 0.01 mg per kg every eight hours.
Take on an empty stomach. Use with Videx (ddI) could increase the risk of peripheral neuropathy (pain in feet) and is not recommended. Dose may need to be decreased if there are kidney problems.
Retrovir
zidovudine
AZT (approved for pediatrics)
  • Syrup: 10 mg per ml.

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  • Capsules: 100 mg.

  • Tablets: 300 mg.
  • Newborn: 2 mg per kg every 6 hours (premature babies the dose is reduced to 1.5 mg per kg every 6 hours).

  • Pediatrics: 160 mg per meter squared (m2) of body surface area every 8 hours. Some use 180 mg per meter squared (m2) of body surface area every 12 hours but this is experimental.
Should not be used with Zerit (d4T). Can be taken with or without food. Dose may need to be decreased if there are kidney or liver problems. Watch for bone marrow depression (decreased red blood cells, white blood cells and/or platelets).
Videx
didanosine
ddI (approved for pediatrics)
  • Pediatric powder for oral solution (mixed with antacid): 10 mg/ml.

  • Buffered powder for oral solution: 100 mg, 167 mg or 250 mg.

  • Chewable tablets: 25 mg, 50 mg, 100 mg or 150 mg.
  • Infants less than 90 days: 50 mg per meter squared (m2) of body surface area every 12 hours.

  • Pediatric dose: 90 mg per meter squared (m2) of body surface area every 12 hours. May need to be higher in children with nervous system disease (maximum dose 150 mg per meter squared (m2).
Keep oral solution refrigerated and shake well before using. Good for only 30 days. Take on an empty stomach: 1 hour before or 2 hours after a meal. When using the chewable tablets, at least two tablets should be chewed to get enough antacid (for example if the dose is 50 mg, take two, 25 mg tablets).
Zerit
stavudine
d4T (approved for pediatrics)
  • Solution: 1 mg per ml.

  • Buffered powder for oral solution: 100 mg, 167 mg or 250 mg.

  • Capsules: 15 mg, 20 mg, 30 mg, or 40 mg.1 mg per kg every 12 hours up to weight of 30 kg.
  • 30 to 59 kg: 30 mg every twelve hours.

  • 60 kg or above: 40 mg every 12 hours.

  • Newborn: dose under study.
Do not use with Retrovir (AZT). Can be taken with or without food. Keep solution refrigerated and shake well before using. Good for only 30 days. Dose may need to be decreased if there are kidney problems.


Protease Inhibitors (PIs)
Drug NameHow SuppliedRecommended DoseSpecial Considerations
Crixivan
indinavir
(not approved for pediatrics)
  • Capsules: 200 or 400 mg.
  • Under investigation: 500 mg per meter squared (m2) of body surface area every 8 hours. Blood levels seem to vary a lot between children and kidney stones may be more common than in adults.
Must be taken on an empty stomach (2 hours after or one hour before a meal) or with a light, non-fat snack. Drink plenty of water to reduce the chances of kidney stones. Dose may need to be decreased if there are liver problems. Do not use with Fortovase. Sustiva and Viramune decrease blood levels of Crixivan; Crixivan dose may need to be increased if used with these drugs. If given with Videx (ddI), give at least one hour apart on an empty stomach.
Invirase/Fortovase
saquinavir
(not approved for pediatrics)
  • Capsules: 200 or 400 mg.
  • Unknown. A dose of 33 mg/kg three times daily has been studied but needs to be adjusted based on the individual child's bl.
Take with food. Do not take with Crixivan or Sustiva. Invirase/Fortovase levels are increased if used with Norvir or Viracept. Doses of Invirase/Fortovase may need to be decreased when used with either Norvir or Viracept.
Norvir
ritonavir
(approved for pediatrics)
  • Solution: 80 mg per ml.

  • Capsules: 100 mg.

  • Chewable tablets: 25 mg, 50 mg, 100 mg or 150 mg.
  • 400 mg per meter squared (m2) of body surface area every 12 hours. To reduce nausea start at 250 mg per meter squared (m2) every 12 hours and increase slowly to the full dose over 5 days.
Keep solution at room temperature and use within 30 days. The capsules must be refrigerated. There are many drug interactions with Norvir. It increases levels of Invirase/Fortovase, Viracept, Crixivan. Other protease inhibitor doses may need to be reduced if taken with Norvir. If taken with Videx (ddI), there should be two hours between each drug. Taking with food may reduce nausea. The solution tastes terrible; some find it easier if taken with chocolate syrup or peanut butter.
Viracept
nelfinavir
(approved for pediatrics)
  • Powder for oral suspension: 50 mg per one level scoopful (200 mg per 1 level teaspoon).

  • Tablets: 250 mg.
  • Pediatric: 20 to 30 mg per kg three times daily. Experimentally, 55 mg per kg every 12 hours has shown to provide better blood levels. This has been studied in very few kids, but it makes sense.

  • Newborn: investigational, 10 mg per kg three times daily being studied.
Take with food. Mix powder with water, milk, pudding, ice cream or formula. Once mixed it's good for up to 6 hours. Do not mix with acidic foods or juice which makes it taste horrible. Alternatively, the tablets dissolve in water and then mix with milk, chocolate milk or pudding. If taken with Crixivan, the levels of both drugs are increased so the doses may need to be reduced. If taken with Norvir, the dose of Viracept may need to be reduced. If taken with Invirase/Fortovase, the dose of Invirase/Fortovase may need to be reduced. Some increase the dose of Viracept if used with Viramune.


Non-Nucleoside Reverse Transcriptase Inhibitors (nnRTIs)
Drug NameHow SuppliedRecommended DoseSpecial Considerations
Rescriptor
delavirdine
(not approved for pediatrics)
  • Tablets: 100 mg.
  • No data on pediatric dosing and not being studied. Adult dose is 400 mg three times daily.
Can dissolve tablets in water if taken promptly. Can be taken with or without food. Do not take with antacids. Increases blood levels of protease inhibitors. Interactions with many different drugs.
Sustiva
efavirenz
(approved for pediatrics)
  • Solution: available only in pediatric clinical trials.

  • Capsules: 50 mg.100 mg or 200 mg.
All doses are once daily:
  • 22 to 32 lbs: 200 mg.

  • 33 to 43 lbs: 250 mg.

  • 44 to 54 lbs: 300 mg.

  • 55 to 71 lbs: 350 mg.

  • 72 to 87 lbs: 400 mg.

  • 88 lbs or more: 600 mg.
Do not use with Fortovase. Decreases levels of Crixivan; doses of Crixivan may need to be increased if used with Sustiva. Can be taken with or without food. Can cause central nervous system side effects (dizziness, impaired concentration, feeling "out of sorts") so it may be better to take it before bed.
Viramune
nevirapine
(approved for pediatrics)
  • Suspension: 50 mg per 5 ml.

  • Tablets: 200 mg.
  • Pediatric up to 8 years old: Begin 4 mg per kg once daily for 14 days; then increase to 7 mg per kg every 12 hours.

  • 8 years or older: Begin 4 mg per kg once daily for 14 days; then increase to 4 mg per kg every 12 hours. Increase dose only if there is no rash and it is tolerated. Do not exceed a total of 400 mg daily.

  • Newborn up to 2 months: under investigation. 5 mg per kg once daily for 14 days; increase to 120 mg per meter squared (m2) of body surface area every twelve hours for 14 days; then increase to 200 mg per meter squared (m2) area every 12 hours if there is no rash and it is tolerated.
Store suspension at room temperature and shake gently before using. Can be taken with or without food. Can be taken at the same time as Videx (ddI). Decreases blood levels of protease inhibitors; doses of protease inhibitors may need to be increased if used with Viramune. Rash usually occurs within six weeks. Do not increase the dose if rash occurs within the first 14 days; call your doctor.


Copyright ©1999 by People With AIDS Working for Health, Inc. Non-commercial reproduction is strongly encouraged.


A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!



  
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This article was provided by PWA Health Group. It is a part of the publication Women's Treatment News.
 
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