| Stavudine
Stavudine (Zerit)
Stavudine
(STAH-vyou-deen)
Pregnancy Category: C Zerit
Classification: Antiviral agent
See Also: See also Antiviral
Agents [. ]
Action/Kinetics: Inhibits
replication of HIV due to phosphorylation by cellular kinases to stavudine triphosphate,
which has antiviral activity. The mechanism for the antiviral activity includes inhibition
of HIV reverse transcriptase by competing with the natural substrate deoxythymidine
triphosphate and by causing DNA chain termination, thereby inhibiting viral DNA synthesis.
Rapidly absorbed. Peak plasma levels: 1 hr or less. t1/2, terminal:
Approximately 1.2 hr. About 40% of the drug is eliminated through the kidney.
Uses: Treatment of adults with
advanced HIV infection who cannot tolerate approved therapies or who have experienced
significant clinical or immunologic deterioration while receiving such therapies (or for
whom such therapies are contraindicated).
Contraindications: Lactation.
Special Concerns: The effect of
stavudine on the clinical progression of HIV infection, such as incidence of opportunistic
infections or survival, has not been determined.
Side Effects: Neurologic:
Peripheral neuropathy (common), including numbness, tingling, or pain in feet or hands. CNS:
Insomnia, anxiety, depression, nervousness, dizziness, confusion, migraine, somnolence,
tremor, neuralgia, dementia. GI: Diarrhea, N&V, anorexia, dyspepsia,
constipation, ulcerative stomatitis, aphthous stomatitis, pancreatitis.
Body as a whole: Headache, chills, fever, asthenia, abdominal pain, back pain,
malaise, weight loss, allergic reactions, flu syndrome, lymphadenopathy, pelvic pain, neoplasms,
death. CV: Chest pain, vasodilation, hypertension, peripheral
vascular disorder, syncope. GU: Dysuria, genital pain, dysmenorrhea, vaginitis,
urinary frequency, hematuria, impotence, urogenital neoplasm. Respiratory: Dyspnea,
pneumonia, asthma. Dermatologic: Rash, sweating, pruritus, maculopapular rash,
benign skin neoplasm, urticaria, exfoliative dermatitis. Ophthalmic:
Conjunctivitis, abnormal vision.
Laboratory Test Alterations:  AST, ALT.
How Supplied: Capsule: 15
mg, 20 mg, 30 mg, 40 mg; Powder for Injection: 1 mg/mL
Dosage
•Capsules Advanced HIV infections.
Adults, initial: 40 mg b.i.d. for clients weighing 60 or more kg and 30 mg b.i.d.
for clients weighing less than 60 kg. In clients developing peripheral neuropathy, the
following dosage schedule may be used if symptoms of neuropathy resolve completely: 20 mg
b.i.d. for clients weighing 60 or more kg and 15 mg b.i.d. for clients weighing less than
60 kg.
The following dosage schedule is recommended for clients with impaired renal function: (a)
CCR greater than 50 mL/min: 40 mg q 12 hr for clients weighing 60 or more kg
and 30 mg q 12 hr for clients weighing less than 60 kg; (b) CCR 26-50 mL/min:
20 mg q 12 hr for clients weighing 60 or more kg and 15 mg q 12 hr for clients weighing
less than 60 kg; (c) CCR 10-25 mL/min: 20 mg q 24 hr for clients weighing 60 or
more kg and 15 mg q 24 hr for clients weighing less than 60 kg. Insufficient data are
available to recommend doses for a CCR less than 10 mL/min or for clients
undergoing dialysis. |
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