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Related to stavudine: zidovudine, nevirapine, delavirdine, didanosine


a nucleoside analogue of thymidine that inhibits replication of the human immunodeficiency virus (HIV); used in the treatment of HIV infection, administered orally.

stavudine (d4T)


Pharmacologic class: Nucleoside reverse transcriptase inhibitor

Therapeutic class: Antiretroviral

Pregnancy risk category C

FDA Box Warning

• Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have occurred with use of drug alone or in combination with other nucleoside analogs. Fatal lactic acidosis has been reported in pregnant women who received stavudine-didanosine combination with other antiretrovirals. Use this combination cautiously in pregnant women and only if potential benefit clearly outweighs potential risk.

• Pancreatitis (fatal and nonfatal cases) has occurred when stavudine was used as part of combination regimen that included didanosine, in both treatment-naive and treatment-experienced patients.


Inhibits replication of human immunodeficiency virus (HIV) by interfering with the enzyme reverse transcriptase, thereby terminating DNA chain


Capsules: 15 mg, 20 mg, 30 mg, 40 mg

Powder for oral solution: 1 mg/ml

Indications and dosages

HIV-1 infection

Adults weighing 60 kg (132 lb) or more: 40 mg P.O. q 12 hours

Adults and children weighing less than 60 kg (132 lb): 30 mg P.O. q 12 hours

Children weighing 30 kg (66 lb) or more: 30 mg P.O. q 12 hours

Children 14 days and older who weigh less than 30 kg (66 lb): 1 mg/kg P.O. q 12 hours

Newborns to infants 13 days old: 0.5 mg/kg P.O. q 12 hours

Dosage adjustment

• Renal impairment

• Elderly patients


• Hypersensitivity to drug or its components


Use cautiously in:

• advanced HIV infection, bone marrow depression, renal failure, peripheral neuropathy, hepatic dysfunction, hyperlactatemia, lactic acidosis

• concurrent use of hydroxyurea or didanosine (avoid use)

• elderly patients (with renal impairment)

• pregnant or breastfeeding patients.


• Give with or without food.

• Know that drug is usually given with other antiretrovirals.

Adverse reactions

CNS: headache, insomnia, peripheral neuropathy

GI: nausea, vomiting, diarrhea, abdominal pain, anorexia, pancreatitis

Hematologic: anemia, leukopenia, thrombocytopenia

Hepatic: hepatic steatosis, hepatitis, hepatic failure

Metabolic: increased glucose tolerance, lactic acidosis

Musculoskeletal: myalgia

Skin: rash

Other: body fat redistribution or accumulation, chills, fever, allergic reaction, immune reconstitution syndrome


Drug-drug. Chloramphenicol, dapsone, didanosine, ethambutol, hydralazine, hydroxyurea, lithium, phenytoin, vincristine, zalcitabine: increased risk of peripheral neuropathy

Doxorubicin, ribavarin, zidovudine: inhibition of stavudine's absorption and metabolism

Myelosuppressants: increased bone marrow depression

Drug-diagnostic tests. Alanine aminotransferase, amylase, aspartate aminotransferase, bilirubin, gamma-glutamyl transferase, lipase: increased levels

Neutrophils, platelets: decreased counts

Patient monitoring

Monitor closely for signs and symptoms of lactic acidosis, hyperlactatemia, or pronounced hepatotoxicity (which may include hepatomegaly and steatosis even in the absence of marked transaminase elevations). Consult prescriber about suspending drug if these occur. Consider permanent discontinuation of drug for patients with confirmed lactic acidosis.

• Monitor patient for signs and symptoms of immune reconstitution syndrome.

• Watch for and report onset and worsening of peripheral neuropathy.

Monitor CBC. Report evidence of bone marrow depression.

• Monitor liver function tests and blood chemistry results.

Patient teaching

• Tell patient he may take with or without food.

Teach patient to recognize and promptly report signs and symptoms of lactic acidosis (such as fatigue, GI distress, and difficult or rapid breathing), hepatotoxicity, immune reconstitution syndrome, and pancreatitis.

• Instruct patient to report numbness or tingling in arms, legs, hands, or feet.

• Caution female patient not to breastfeed, because she may transmit drug effects and HIV to infant.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.


/stav·u·dine/ (stav´u-dēn) a nucleoside analogue of thymidine that inhibits human immunodeficiency virus (HIV) replication, used in the treatment of HIV infection.


An antiviral drug, C10H12N2O4, that is a nucleoside reverse transcriptase inhibitor and is used in the treatment of HIV infection. Also called d4T.


a synthetic thymidine nucleoside analog.
indications It is prescribed in combination with other drugs for the treatment of adults with advanced human immunodeficiency virus (HIV) infection, generally those who are intolerant of other approved therapies.
contraindications Hypersensitivity to this drug or to any of its components prohibits its use.
adverse effects The side effects most often reported include peripheral neuropathies (occur more commonly than with comparable medications), elevation of hepatic transaminase levels, headache, chills, fever, asthenia, abdominal pain, diarrhea, nausea, and vomiting.


d4T, Zerit® AIDS An antiretroviral nucleoside analogue used in multiagent management of AIDS Adverse effects Lactic acidosis, severe hepatomegaly with steatosis, severe peripheral neuropathy. See AIDS.


A REVERSE TRANSCRIPTASE INHIBITOR drug used to treat HIV infections. The drug is on the WHO official list. A brand name is Zerit.

stavudine (stav´ūdēn´),

n brand name: Zerit;
drug class: antiviral;
action: inhibits replication of human immunodeficiency virus (HIV);
uses: treatment of adults with advanced HIV infection who are intolerant of other therapies or who have significant deterioration while receiving other therapies.
References in periodicals archive ?
Lactic acidosis is one of the severe forms of ADR seen with AZT and stavudine.
6 ADRs: Adverse drug reactions Figure 1: Frequency of adverse drug reactions caused by antiretroviral drugs Types of ADRs Anemia (15) Rash (13) Hepatitis (4) Zidovudine (18) 15 Nevirapine (13) 10 3 Stavudine (10) Tenofovir (5) Emtricitabine (4) Abacavir (3) 3 Lamivudine (1) 1 Atazanavir (1) Didanosine (1) Lipodystrophy (5) Hyper- Vomiting (3) pigmentation (5) Zidovudine (18) 1 Nevirapine (13) Stavudine (10) Tenofovir (5) 5 1 Emtricitabine (4) 3 1 Abacavir (3) Lamivudine (1) Atazanavir (1) Didanosine (1) Peripheral Pancreatitis Diarrhoea Acute neuropathy (4) (2) (2) renal injury (3) Zidovudine (18) Nevirapine (13) Stavudine (10) 2 2 1 Tenofovir (5) 1 3 Emtricitabine (4) Abacavir (3) Lamivudine (1) Atazanavir (1) 1 Didanosine (1) 1 Note: Table made from bar graph.
Patients receiving antiretroviral therapy are usually recieving 3 drugs, and this study's main finding is that the percentage of depressive features was higher among participants using the regimen of stavudine, lamivudine and efavirenz (58%) followed by those who were taking stavudine, lamivudine and nevirapine (24.
At the time of the present study, a combination regimen of stavudine, lamivudine, and efavirenz was the recommended first-line regimen, with nevirapine replacing efavirenz for women of childbearing age.
All patients who developed anaemia were shifted to stavudine based therapy.
In sweeping changes to its guidelines, the WHO said"that countries progressively phase out the use of stavudine as a preferred first-line therapy option and move to less toxic alternatives such as zidovudine (AZT) or tenofovir (TDF).
Peripheral neuropathy is especially common among patients being treated for tuberculosis and also taking stavudine for their HIV/AIDS treatment.
In this study, the data regarding to the total cholesterol levels in Groups 3, 4 and 5 were elevated in patients percentual in concordance with the literature data, reaching prevalence that ranges from 31% to 47%, when receiving HAART regimens including Protease Inhibitors (PIs) or Stavudine.
A triple combination of antiretrovirals lamivudine, stavudine and nevirapine will soon be available in the Cuban market, says Marlen Espino, director of state-funded pharmaceutical producer Novatec Laboratories.
We see less peripheral neuropathy as fewer patients are on combinations involving didanosine and stavudine [2];