Pharm

Stavudine

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Stavudine, d4T, Zerit

  • See Also
  1. Anti-Retroviral Therapy
  2. Nucleoside Reverse Transcriptase Inhibitor
  • Indications
  1. HIV Infection
    1. Other nRTI agents with fewer adverse effects (e.g. Peripheral Neuropathy) have replaced Stavudine
  • Mechanism
  1. Nucleoside Reverse Transcriptase Inhibitor (nRTI)
  2. Inhibits HIV replication
  • Pharmacokinetics
  1. Well absorbed with 83% Bioavailability
  • Efficacy
  1. Increases CD4 Counts and suppresses HIV p24 Antigenemia
    1. Doses of 0.1-2.0 mg/day
    2. Dose related response (better at higher doses)
  2. Very little HIV resistance after release
  • Dosing
  1. Stavudine 40 mg orally twice daily
  • Adverse Effects
  1. See nRTI for adverse effects attributed to the class
  2. Less Bone Marrow toxicity than Zidovudine (AZT)
  3. Headache
  4. Nausea, Vomiting
  5. Asthenia, confusion
  6. Serum Aminotransferase elevation
  7. Creatine Kinase elevation
  8. Lipodystrophy
  9. Hyperlipidemia
  10. Glucose intollerance to Diabetes Mellitus
  11. Lactic Acidosis
    1. Potentially lethal
    2. Higher risk when used in combination with Didanosine
  12. Moderate painful sensory Peripheral Neuropathy
    1. Most common serious side effect (more than other nRTI agents)
    2. Dose related (may not recur if restart at lower dose)
  13. Pancreatitis and hyperamylasemia (rare)
  • Resources
  1. Stavudine for solution (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=17e597bc-d663-4d8e-a5d3-39816b628996
  2. Stavudine Capsules (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7501de1e-149d-405e-94f6-da4010952adf
  • References
  1. (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
  2. (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]
  3. Reust (2011) Am Fam Physician 83(12): 1443-51 [PubMed]