Commonly Used HIV Drugs in Pediatrics

This page gives a brief overview of commonly used antiretroviral drugs in children. Paediatric ART is specialised and dosing must follow the latest national paediatric HIV guidelines (weight-band dosing) or advice from an HIV/paediatrics specialist.

In the ED:
• Confirm and continue the child’s existing regimen where possible.
• Avoid making major changes to chronic ART without HIV clinic/paeds input.
• For PEP or new starts, follow the dedicated HIV PEP/ART protocol rather than this summary table.
Do not rely on this page alone to calculate ART doses. Always check the latest paediatric HIV guideline, weight-band tables, and potential drug–drug interactions.

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Common Paediatric HIV Drugs (Overview)

Drug Typical Paediatric Dosing Approach Route Indication / Role Precautions
Tenofovir disoproxil fumarate (TDF) Weight-band dosing; commonly around 8 mg/kg once daily (maximum usually 300 mg) – follow national guideline tables. Oral NRTI backbone for HIV-1 in children meeting age/weight criteria (often ≥ 2 years and appropriate weight). Monitor renal function (creatinine, eGFR) and bone health. Use with caution in renal impairment or low body weight.
Emtricitabine (FTC) Weight-band dosing; typical range approx. 3–6 mg/kg once daily (maximum usually 200 mg) – follow guideline tables. Oral NRTI used with TDF or other agents as part of combination ART. Generally well tolerated; adjust dose in renal impairment. Monitor for gastrointestinal upset and other adverse effects.
Dolutegravir (DTG) Strict weight-band dosing (mg once daily) – consult paediatric HIV guideline. Often used in children ≥ 6 years / specific weight thresholds. Oral Integrase inhibitor; now preferred in many first-line paediatric regimens. Check for drug interactions (e.g. rifampicin, some antacids). Monitor for neuropsychiatric symptoms and GI side effects.
Raltegravir (RAL) Granules or tablets with weight-band dosing; doses vary by age and formulation – use paediatric tables. Oral Integrase inhibitor; used in infants and children from ~4 weeks of age in certain regimens. Monitor for GI upset, insomnia, and potential interactions. Check formulation-specific dosing carefully.
Atazanavir (ATV) Boosted regimen (usually with ritonavir). Weight-band and age-dependent dosing – follow specialist guideline. Oral Protease inhibitor used in combination therapy in older children/adolescents. Monitor for hyperbilirubinaemia, jaundice, and drug interactions (e.g. PPIs, some anticonvulsants). Check liver function tests.