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Zalcitabine
Aka: Zalcitabine, ddC, Hivid
- See Also
- Anti-Retroviral Therapy
- Nucleoside Reverse Transcriptase Inhibitor
- Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Inhibits HIV replication
- Pharmacokinetics
- Well absorbed (87% oral bioavailability)
- Efficacy
- 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
- Dosing
- Zalcitabine 0.75 mg PO tid ($207/month)
- Adverse Effects
- See nRTI for adverse effects attributed to the class
- Common symptoms during the first several weeks
- Effects
- Maculovesicular cutaneous eruptions
- Mucosal Ulcers
- Fevers
- Symptoms often resolve without stopping medication
- Consider Symptomatic therapy
- Tylenol
- Antihistamines
- NSAIDS
- Symptoms less frequent at a dose of 2.25 mg/day
- 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%)
- 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]