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Stavudine
Aka: Stavudine, d4T, Zerit
- See Also
- Anti-Retroviral Therapy
- Nucleoside Reverse Transcriptase Inhibitor
- Mechanism
- Nucleoside Reverse Transcriptase Inhibitor (nRTI)
- Inhibits HIV replication
- Pharmacokinetics
- Well absorbed with 83% bioavailability
- Efficacy
- Increases CD4 Counts and suppresses HIV p24 Antigenemia
- Doses of 0.1-2.0 mg/day
- Dose related response (better at higher doses)
- Very little resistance currently
- Dosing
- Stavudine 40 mg PO bid ($224/month)
- Toxicity
- Less Bone Marrow toxicity than Zidovudine (AZT)
- Adverse Effects
- See nRTI for adverse effects attributed to the class
- Headache
- Nausea, Vomiting
- Asthenia, confusion
- Serum Aminotransferase elevation
- Creatine Kinase elevation
- Lipodystrophy
- Hyperlipidemia
- Glucose intollerance to Diabetes Mellitus
- Lactic Acidosis
- Potentially lethal
- Higher risk when used in combination with Didanosine
- Moderate painful sensory Peripheral Neuropathy
- Most common serious side effect (more than other nRTI agents)
- Dose related (may not recur if restart at lower dose)
- Pancreatitis and hyperamylasemia (rare)
- References
- (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
- (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]
- Reust (2011) Am Fam Physician 83(12): 1443-51 [PubMed]