II. Indications
-
HIV Infection (Anti-Retroviral Therapy)
- Replaced by other more potent nRTI with less frequent dosing, and less severe adverse effects
III. Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Inhibits HIV replication
IV. Pharmacokinetics
- Well absorbed (87% oral Bioavailability)
V. Efficacy
- Replaced by other nRTIs with greater potency
- Combination treatment Zalcitabine and Zidovudine (AZT)
- Late HIV without prior Anti-Retroviral Therapy
- Large and sustained CD4 Count increase
- Improves survival in patients with late HIV disease
VI. Dosing
- Zalcitabine 0.75 mg orally THREE times daily
VII. Adverse Effects
- See nRTI for adverse effects attributed to the class
- More significant adverse effects than newer nRTI agents
- Common symptoms during the first several weeks
- Effects
- Maculovesicular cutaneous eruptions
- Mucosal Ulcers
- Fevers
- Symptoms often resolve without stopping medication
- Consider Symptomatic therapy
- Symptoms less frequent at a dose of 2.25 mg/day
- Effects
- Painful Sensorimotor leg Peripheral Neuropathy (10-25%)
- Major dose limiting toxicity
- Discontinue drug at first signs of Neuropathy!
- Symptoms usually resolve over a few weeks
- Pancreatitis (<1%)