Zidovudine: What It Is, How It Works, and What You Need to Know

When you hear zidovudine, a nucleoside reverse transcriptase inhibitor used to treat HIV infection. Also known as AZT, it was the first drug approved by the FDA to fight HIV back in 1987. Back then, it was a miracle. Today, it’s not the first choice for most people starting HIV treatment—but it’s still in use, often in combination with other drugs, especially in pregnant women to prevent mother-to-child transmission.

Zidovudine works by blocking an enzyme HIV needs to copy itself. Without that enzyme, the virus can’t make new copies of its genetic material. That’s why it’s part of what’s called antiretroviral therapy. But it doesn’t work alone. Taking zidovudine by itself can lead to resistance fast. That’s why it’s almost always paired with other drugs like lamivudine or tenofovir. You’ll also see it in combo pills like Combivir and Trizivir. If you’re on zidovudine, you’re likely also managing side effects like nausea, headaches, or fatigue. In rare cases, it can affect your bone marrow, lowering red or white blood cell counts. That’s why regular blood tests are part of the routine.

It’s not just about the drug itself—it’s about how it fits into the bigger picture of HIV care. People taking zidovudine often need to avoid other medications that stress the liver or bone marrow. For example, if you’re also on certain antibiotics or cancer drugs, your doctor will need to check for interactions. And because zidovudine is used in pregnancy, there’s a lot of data on how it affects newborns. Studies show it cuts transmission risk by more than 70% when taken correctly during pregnancy and delivery.

There’s also the issue of generic versions. While brand-name Retrovir is still around, most people take the generic form. But not all generics are created equal. Some overseas manufacturing plants have had FDA warnings for quality issues—same as with other HIV meds. That’s why knowing where your pills come from matters. If you’re switching brands or suppliers, your doctor might want to check your viral load to make sure the new version is working just as well.

What you’ll find in the posts below are real-world stories and facts about how zidovudine fits into the world of HIV treatment. You’ll see how it compares to newer drugs, what to expect when you start it, how it interacts with other meds, and why some patients still rely on it decades after it was first approved. Whether you’re a patient, a caregiver, or just trying to understand the history of HIV care, this collection gives you the clear, no-fluff details you need.