zalcitabine

Generic Name: zalcitabine (zal SITE ta been)
Brand Name: Hivid

What is zalcitabine?

Zalcitabine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Zalcitabine is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Zalcitabine is not a cure for HIV or AIDS.

Zalcitabine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about zalcitabine?

Zalcitabine may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.

Zalcitabine can also cause severe or life-threatening effects on your liver or pancreas. Call your doctor at once if you have any of these symptoms while taking zalcitabine: severe pain in your upper stomach spreading to your back, fast heart rate, nausea and vomiting, diarrhea, loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Slideshow: Flashback: FDA Drug Approvals 2013

Before taking this medication, tell your doctor if you have kidney disease, liver disease, a history of pancreatitis, or if you have used a medicine similar to zalcitabine in the past, such as abacavir (Ziagen), didanosine (Videx), lamivudine (Epivir), stavudine (Zerit), tenofovir (Viread), or zidovudine (Retrovir).

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

Taking zalcitabine will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

What should I discuss with my healthcare provider before taking zalcitabine?

Do not use this medication if you are allergic to zalcitabine.

Before taking this medication, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney disease;

  • liver disease (including hepatitis B);

  • a history of pancreatitis; or

  • if you have used a medicine similar to zalcitabine in the past, such as abacavir (Ziagen), didanosine (Videx), lamivudine (Epivir), stavudine (Zerit), tenofovir (Viread), or zidovudine (Retrovir).

If you have any of the conditions listed above, you may not be able to use zalcitabine or you may need a dosage adjustment or special tests during treatment.

Zalcitabine may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis symptoms can start slowly and gradually get worse. Symptoms include unusual muscle pain and weakness, trouble breathing, fast or uneven heart rate, nausea, vomiting, stomach pain, and numbness or cold feeling in your arms or legs. Call your doctor at once if you have any of these symptoms, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.

Zalcitabine can also cause severe or life-threatening effects on your liver or pancreas. Call your doctor at once if you have any of these symptoms while taking zalcitabine: severe pain in your upper stomach spreading to your back, fast heart rate, nausea and vomiting, diarrhea, loss of appetite, low fever, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Your name may need to be listed on an antiviral pregnancy registry when you start using zalcitabine. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether zalcitabine had any effect on the baby.

You should not breast-feed while you are using zalcitabine. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

How should I take zalcitabine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take zalcitabine with a full glass of water.

Zalcitabine is usually taken every 8 hours, but if you have kidney disease you may need to take it every 12 or 24 hours. Follow your doctor's instructions.

Take zalcitabine on an empty stomach, at least 1 hour before or 2 hours after a meal. This will make it easier for your body to absorb the medicine.

It is important to use zalcitabine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.

To be sure this medication is helping your condition, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Store zalcitabine in a tightly closed container at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a zalcitabine overdose may include nausea or drowsiness.

What should I avoid while taking zalcitabine?

Avoid using antacids without your doctor's advice. Use only the specific type of antacid your doctor recommends. Antacids contain different medicines and some types can make it harder for your body to absorb zalcitabine.

Avoid drinking alcohol while taking zalcitabine. Alcohol may increase the risk of damage to the pancreas and/or liver.

Taking zalcitabine will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

Zalcitabine side effects

Stop using zalcitabine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these other serious side effects:

  • liver damage - nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • lactic acidosis - muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, nausea with vomiting, and fast or uneven heart rate;

  • pancreatitis - severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • peripheral neuropathy - numbness, tingling, or pain in your hands or feet;

  • easy bruising or bleeding, unusual weakness, pale skin;

  • white patches or sores inside your mouth or on your lips;

  • seizure (convulsions);

  • fever, chills, body aches, flu symptoms; or

  • any other signs of new infection.

Less serious side effects may be more likely to occur, such as:

  • mild nausea, vomiting, stomach pain, diarrhea, constipation;

  • headache, tired feeling;

  • skin rash; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and trunk).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

See also: Side effects (in more detail)

Zalcitabine dosing information

Usual Adult Dose for HIV Infection:

0.75 mg orally every 8 hours.

What other drugs will affect zalcitabine?

Before taking zalcitabine, tell your doctor if you are using any of the following drugs:

  • cimetidine (Tagamet);

  • foscarnet (Foscavir);

  • nitrofurantoin (Furadantin, Macrobid, Macrodantin);

  • probenecid (Benemid);

  • amphotericin B (Fungizone, AmBisome, Amphotec, Abelcet);

  • an antibiotic such as amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), neomycin (Mycifradin, Neo-Fradin, Neo-Tab), netilmicin (Netromycin), streptomycin, tobramycin (Nebcin, Tobi); or

  • other drugs that can affect the pancreas, such as asparaginase (Elspar), azathioprine (Imuran), estrogens (birth control or hormone replacement), furosemide (Lasix), methyldopa (Aldomet), pentamidine (Nebupent), sulindac, valproic acid (Depakene), diuretics (water pills), sulfa drugs, or tetracycline antibiotics.

If you are using any of these drugs, you may not be able to use zalcitabine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect zalcitabine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has information about zalcitabine written for health professionals that you may read.

What does my medication look like?

Zalcitabine is available with a prescription under the brand name Hivid. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Hivid 0.375 mg--oval, beige, film-coated tablets

  • Hivid 0.750 mg--oval, gray, film-coated tablets

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.03. Revision Date: 2007-04-26, 8:35:39 AM.

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