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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