Stavudine

Brand names: Zerit

Why is Stavudine prescribed?

Zerit is one of the drugs used to fight the human immunodeficiency virus (HIV)—the deadly cause of AIDS. It is usually prescribed for people who have already been taking the HIV drugs for an extended period. HIV attacks the immune system, slowly destroying the body's ability to fight off infection. Zerit helps stave off the attack by disrupting the virus's ability to reproduce.

Most important fact about Stavudine

Although Zerit can slow the progress of HIV infection, it is not a cure. Because of the continuing danger of complications and infections, you should get frequent physical exams and blood counts. Be sure, too, to notify your doctor immediately if you experience any changes in your general health.

How should you take Stavudine?

Take Zerit every 12 hours, exactly as prescribed. It's important to keep a constant level of the drug in the body, so be sure to take each dose on schedule. Do not take more than the prescribed amount; nerve disorders could result.

Shake the oral solution vigorously before measuring the dose.

You can take Zerit with or without food.

• If you miss a dose...
  Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

• Storage instructions...
  Keep the Zerit container tightly closed. Store the capsules at room temperature. Store Zerit oral solution in the refrigerator; throw out any unused medication after 30 days.

What side effects may occur?

Side effects are more likely if you combine Zerit with other drugs that cause similar reactions. Also, the higher your dosage of Zerit, the greater the chance of a problem. However, it's often hard to tell a side effect from a symptom of the disease. If you think the drug is causing problems, keep taking it until you've checked with your doctor. Only your doctor can determine whether the drug is at fault, and adjust your dosage accordingly.

• Side effects may include:
  Abdominal pain, allergic reaction, chills, diarrhea, fever, headache, liver damage, loss of appetite, muscle pain, nausea and vomiting, nervous system abnormalities, pain or numbness and tingling in the hands and feet, pancreatitis, rash, sleeplessness

Why should Stavudine not be prescribed?

If Zerit gives you an allergic reaction, you should not take the drug.

Special warnings about Stavudine

Remember that Zerit does not prevent the spread of HIV through sexual contact or contact with infected blood.

Zerit has been known to cause severe and even fatal liver damage, especially in women, overweight individuals, and people who have been taking Zerit or similar medications for a long time. The risk increases if you're being treated with a combination of Zerit, didanosine and hydroxyurea. Signs of a liver problem include weight loss, weakness, fatigue, abdominal pain, nausea, vomiting, and shortness of breath. If you develop these symptoms, call your doctor immediately; treatment with Zerit may have to be stopped. Also be sure to tell the doctor if you've ever had a liver problem or tend to abuse alcohol; the doctor will watch especially closely for any sign of a liver problem.

Zerit can also cause serious and even fatal pancreatitis, especially if you've had the problem in the past, suffer from gallstones, or drink alcoholic beverages. Combining Zerit with didanosine increases the risk. Check with your doctor immediately if you develop such signs of pancreatitis as stomach pain, nausea, or vomiting; you may have to stop treatment with Zerit. If you have any of the risk factors for pancreatitis, make sure the doctor is aware of it.

One of the more common and dangerous side effects of Zerit is a problem called peripheral neuropathy, a serious condition in which certain nerves are damaged. If you notice numbness, tingling, or pain in your hands or feet, notify your physician immediately. Treatment with Zerit may have to be stopped.

Another side effect seen in some people receiving drugs for HIV is a redistribution of body fat, leading to extra fat around the middle, a "buffalo hump" on the back, and wasting in the arms, legs, and face. Researchers don't know whether this represents a long-term health problem or not.

The benefit you get from Zerit may not last long. If your symptoms begin to get worse, tell your doctor immediately.

Possible food and drug interactions when taking Stavudine

Combining Zerit with any of the following drugs may make peripheral neuropathy worse.

Chloramphenicol
Cisplatin
Dapsone
Didanosine
Ethambutol
Hydralazine
Lithium
Metronidazole
Nitrofurantoin
Phenytoin
Vincristine
Zalcitabine
Zidovudine

Remember, too, that combination therapy with Zerit, didanosine, and hydroxyurea increases the possibility of serious liver problems. Combining Zerit and didanosine also increases the risk of pancreatitis.

Special information if you are pregnant or breastfeeding

The possibility that Zerit may harm a developing baby has not been ruled out. The drug should be used during pregnancy only if its benefits seem to outweigh the possible risk. The combination of Zerit and didanosine should be used with particular caution during pregnancy due to the danger of liver damage.

Do not breastfeed; HIV can be passed to a newborn infant through breast milk.

Recommended dosage for Stavudine

ADULTS

For adults weighing 132 pounds or more, the usual dose is 40 milligrams every 12 hours. For those under 132 pounds, the dose is 30 milligrams every 12 hours.

CHILDREN

The usual starting dose for children weighing less than 66 pounds is 1 milligram per 2.2 pounds of body weight every 12 hours. Children weighing 66 pounds or more should take the adult dose.

Dosage is often reduced for people with kidney problems.

Overdosage

Numbness, pain, and tingling of the hands and feet can be signs of an overdose. If you suspect an overdose, seek medical attention immediately.