II. Indications

  1. HIV Infection
    1. Other nRTI agents with fewer adverse effects (e.g. Peripheral Neuropathy) have replaced Stavudine

III. Mechanism

IV. Pharmacokinetics

  1. Well absorbed with 83% Bioavailability

V. 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

VI. Dosing

  1. Stavudine 40 mg orally twice daily

VII. 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)

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Ontology: Stavudine (C0164662)

Definition (NCI_NCI-GLOSS) A drug that belongs to the family of drugs called nucleoside analogues. It is used to treat infection caused by viruses.
Definition (NCI) A nucleoside reverse transcriptase inhibitor analog of thymidine. Stavudine has been recommended to undergo phase-out management due to its long-term, irreversible side-effects.
Definition (CSP) nucleoside analog; used as an antiviral agent.
Definition (MSH) A dideoxynucleoside analog that inhibits reverse transcriptase and has in vitro activity against HIV.
Definition (PDQ) A synthetic nucleoside, analog of didehydro-3-deoxythymidine with potent antiretroviral activity. In vivo, stavudine is phosphorylated by cellular kinases to the active metabolite stavudine triphosphate; this metabolite inhibits the activity of HIV reverse transcriptase both by competing with the natural substrate deoxythymidine triphosphate and by incorporation into viral DNA causing a termination of DNA chain elongation (due to the lack the essential 3'-OH group). Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41064&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41064&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1428" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH D018119
SnomedCT 108690008, 386895008
LNC LP21315-4, MTHU013858
English D4T, Stavudine, 2',3'-Didehydro-2',3'-dideoxythmidine, 2',3'-Didehydro-3'-deoxythymidine, 2',3' Didehydro 3' deoxythymidine, Thymidine, 2',3'-didehydro-3'-deoxy-, 3'-Deoxy-2'-thymidinene, 1-(2,3-Dideoxy-beta-glycero-pent-2-enofuranosyl)thymine, stavudine, DIDEHYDRODEOXYTHYMIDINE 02 03 03, D A 004 T, Dideoxydidehydrothymidine, 2'3' didehydro 3' deoxythymidine, 2'3' didehydrodeoxythymidine, stavudine (medication), STAVUDINE, Stavudine [Chemical/Ingredient], d4t, Stavudine (product), Stavudine (substance), dideoxydidehydrothymidine, didehydrodeoxythymidine, d4T, Didehydrodeoxythymidine, STAVUDINE (d4T)
German 2,3-Didehydro-3-Desoxythymidin, DIDEHYDRODESOXYTHYMIDIN 02 03 03, D A 004 T, 2',3'-Didehydro-3'-Desoxythymidin, D4T, Stavudin
Swedish Stavudin
Czech stavudin
Finnish Stavudiini
Russian STAVADIN, STAVUDIN, DEGIDRODEZOKSITIMIDIN, 2',3'-DIDEGIDRO-3'-DEZOKSITIMIDIN, D4T, 2',3'-ДИДЕГИДРО-3'-ДЕЗОКСИТИМИДИН, ДЕГИДРОДЕЗОКСИТИМИДИН, СТАВАДИН, СТАВУДИН
Japanese サニルブジン, スタブジン, 2',3'-ジデヒドロ-3'-デオキシチミジン
Polish Stawudyna, D4T
Portuguese 2',3'-Didesidro-3'-desoxitimidina, D4T, Estavudina
Spanish estavudina (producto), estavudina (sustancia), estavudina, D4T, 2',3'-Didehidro-3'-desoxitimidina, Estavudina
French 2,3'-didehydro-3'-deoxythymidine, d4T, Stavudine
Italian Stavudina

Ontology: Zerit (C0701312)

Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH D018119
German Zerit
English zerit, Zerit, Bristol-Myers Brand of Stavudine, Bristol-Myers Squibb Brand of Stavudine