Pharm

Stavudine

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Stavudine, d4T, Zerit

  • Mechanism
  • Pharmacokinetics
  1. Well absorbed with 83% bioavailability
  • 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 resistance currently
  • Dosing
  1. Stavudine 40 mg PO bid ($224/month)
  • Toxicity
  1. Less Bone Marrow toxicity than Zidovudine (AZT)
  • Adverse Effects
  1. See nRTI for adverse effects attributed to the class
  2. Headache
  3. Nausea, Vomiting
  4. Asthenia, confusion
  5. Serum Aminotransferase elevation
  6. Creatine Kinase elevation
  7. Lipodystrophy
  8. Hyperlipidemia
  9. Glucose intollerance to Diabetes Mellitus
  10. Lactic Acidosis
    1. Potentially lethal
    2. Higher risk when used in combination with Didanosine
  11. 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)
  12. Pancreatitis and hyperamylasemia (rare)