Stavudine is an oral medication that is used for the treatment of infections with the human immunodeficiency virus (HIV). It is in a class of drugs called reverse transcriptase inhibitors which also includes zalcitabine (Hivid), zidovudine (Retrovir), didanosine (Videx), and lamivudine (Epivir). During infection with HIV, the HIV virus multiplies within the body's cells. The newly formed viruses are released from the cells and spread throughout the body where they infect other cells. In this manner the infection continually spreads to new uninfected cells that the body is continually producing, perpetuating HIV infection. When producing new viruses, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the enzyme that the virus uses to form this new DNA. Specifically, stavudine is converted within the body to its active form (stavudine triphosphate). This active form is similar to thymidine triphosphate, a chemical that is used by the HIV virus to make new DNA. The reverse transcriptase uses stavudine triphosphate instead of thymidine triphosphate for making DNA, and the stavudine triphosphate interferes with the action of the reverse transcriptase. Stavudine does not kill existing HIV virus, and it is not a cure for HIV. Stavudine was approved by the FDA in June 1994.

Zerit

GENERIC AVAILABLE: Yes

Yes

The most severe side effects are:

• a decrease in blood cells,
• muscle pain (myopathy),
• pancreatitis (inflammation of the pancreas),
• liver failure, and
• metabolic disturbance (lactic acidosis).

Stavudine damages nerves and can cause a severe peripheral neuropathy, a condition in which sensation in the legs and/or arms is altered or lost. Symptoms of peripheral neuropathy are tingling, numbness and pain in the feet or hands.

Other side effects include

• chills,
• rash,
• abdominal pain,
• weight loss and
• insomnia.

The recommended dose for adults is 40 mg every 12 hours for those weighing 60 kg or more and 30 mg every 12 hours if less than 60 kg.

Newborns up to 13 days of age should receive 0.5 mg/kg every 12 hours and children older than 14 days and weighing less than 30 kg should receive 1 mg/kg.

Children weighing 30 kg or more should be treated as adults.

Stavudine may be administered without regard to meals.

It is not known whether stavudine is excreted in breast milk. HIV infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.

What preparations of stavudine are available?

Capsules: 15, 20, 30 and 40 mg. Powder for oral solution, 1 mg/ml.

How should I keep stavudine stored?

Capsules should be stored at room temperature, 15 C to 30 C (59 F to 86 F). The dry powder for oral solution should be kept at room temperature and away from moisture. Solutions should be refrigerated.