From the FDA Drug Label
DOSAGE AND ADMINISTRATION Pediatric Patients Aged 3 Months and Older: Administered either once or twice daily. Dose should be calculated on body weight (kg) and should not exceed 300 mg daily.
The recommended dosage of Lamivudine in pediatric patients is 4 mg/kg twice daily, not to exceed 300 mg daily.
- For Zidovudine, the dosage is 160 mg/m2 3 times daily in pediatric subjects. There is no information in the provided drug labels regarding the recommended dosages for Kaletra (Lopinavir/Ritonavir) and Dolutegravir in pediatric patients.
- Lamivudine: 4 mg/kg twice daily, not to exceed 300 mg daily 1
- Zidovudine: 160 mg/m2 3 times daily 1 No information is available for Kaletra (Lopinavir/Ritonavir) and Dolutegravir.
From the Research
The recommended dosages for antiretroviral medications in pediatric patients are as follows: Zidovudine (AZT) 90 mg/m² per dose twice daily, Lamivudine (3TC) 4 mg/kg twice daily, Kaletra (lopinavir/ritonavir) 120/30 mg/m² or 12/3 mg/kg twice daily for 15-40 kg, and Dolutegravir 20-50 mg daily based on weight. These dosages are based on the most recent and highest quality study available, which provides guidance on the optimal dosing for pediatric patients 2. The study found that the LPV/r:3TC:ZDV(ABC) dose ratios were 2.67:1:2(2), respectively, and that reducing the LPV/ZDV dose to 80/60 mg bid decreased the frequency of high ZDV concentrations while retaining the LPV efficacy criteria. The following are the specific dosing recommendations for each medication:
- Zidovudine (AZT): 90 mg/m² per dose twice daily
- Lamivudine (3TC): 4 mg/kg twice daily
- Kaletra (lopinavir/ritonavir): 120/30 mg/m² or 12/3 mg/kg twice daily for 15-40 kg
- Dolutegravir: 20-50 mg daily based on weight It is essential to note that these dosages may require adjustment based on individual patient factors, such as renal or hepatic impairment, and that the medications should be taken consistently at the same times each day to maintain therapeutic blood levels 3, 4. Additionally, the combination of these medications targets multiple stages of the viral life cycle to effectively suppress viral replication and prevent resistance, which is critical for achieving optimal treatment outcomes in pediatric patients with HIV infection 5.