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Zerit (stavudine) Disease Interactions

There are 5 disease interactions with Zerit (stavudine):

Major

Nrtis (Includes Zerit) ↔ Bone Marrow Suppression

Severe Potential Hazard, Moderate plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

The nucleoside reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC) and stavudine (d4T), may infrequently cause bone marrow suppression at recommended dosages. Anemia, leukopenia, thrombocytopenia and neutropenia have been reported. Therapy with these agents should be administered cautiously in patients with preexisting bone marrow depression or blood dyscrasias. Routine blood counts are recommended.

References

  1. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  3. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nrtis (Includes Zerit) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Liver Disease

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has rarely been associated with the use of nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronouced hepatotoxicity occur.

References

  1. Dolin R, Lambert JS, Morse GD, et al "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  2. Montaner JSG, Rachlis A, Beaulieu R, Gill J, Schlech W, Phillips P, Auclair C, Boulerice F, Schindzielorz A, Smaldone L, Wainber "Safety profile of didanosine among patients with advanced HIV disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program." J Acquir Immune Defic Syndr 7 (1994): 924-30
  3. Yarchoan R, Mitsuya H, Pluda JM, et al "The National Cancer Institute phase I study of 2',3'-dideoxyinosine administration in adults with AIDS-related complex: analysis of activity and toxicity profiles." Rev Infect Dis 12 (1990): s522-33
  4. Lai KK, Gang DL, Zawacki JK, Cooley TP "Fulminant hepatic failure associated with 2',3'-dideoxyinosine (ddI)." Ann Intern Med 115 (1991): 283-4
  5. Pike IM, Nicaise C "The didanosine Expanded Access Program: safety analysis." Clin Infect Dis 16 (1993): S63-8
  6. "Product Information. Viread (tenofovir)." Gilead Sciences, Foster City, CA.
  7. Pai VB, Koranyi K, Nahata MC "Acute hepatitis and bleeding possibly induced by zidovudine and ritonavir in an infant with HIV infection." Pharmacotherapy 20 (2000): 1135-40
  8. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Gradon JD, Chapnick EK, Sepkowitz DV "Zidovudine-induced hepatitis." J Intern Med 231 (1992): 317-8
  10. Chen SC, Barker SM, Mitchell DH, et al "Concurrent zidovudine-induced myopathy and hepatoxicity in patients treated for human immunodeficiency virus (HIV) infection." Pathology 24 (1992): 109-11
  11. Shriner K, Goetz MB "Severe hepatoxicity in a patient receiving both acetaminophen and zidovudine." Am J Med 93 (1992): 94-6
  12. Boubaker K, Flepp M, Sudre P, et al. "Hyperlactatemia and Antiretroviral Therapy: The Swiss HIV Cohort Study." Clin Infect Dis 33 (2001): 1931-7
  13. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  14. Miller KD, Cameron M, Wood LV, Dalakas MC, Kovacs JA "Lactic acidosis and hepatic steatosis associated with use of stavudine: report of four cases." Ann Intern Med 133 (2000): 192-6
  15. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  16. "Product Information. Ziagen (abacavir)." Glaxo Wellcome, Research Triangle Pk, NC.
  17. Lonergan JT, Behling C, Pfander H, Hassanein TI, Mathews WC "Hyperlactatemia and hepatic abnormalities in 10 human immunodeficiency virus-infected patients receiving nucleoside analogue combination regimens." Clin Infect Dis 31 (2000): 162-6
  18. Lhouri S, Cushing H "Lactic acidosis secondary to nucleoside analog antiretroviral therapy." Infect Med 17 (2000): 547-54
  19. Dubin G, Braffman MN "Zidovudine-induced hepatotoxicity." Ann Intern Med 110 (1989): 85-6
  20. Shintaku M, Nasu K, Shimizu T "Fulminant hepatic failure in an AIDS patient: possible zidovudine- induced hepatotoxicity." Am J Gastroenterol 88 (1993): 464-6
  21. Coghlan ME, Sommadossi JP, Jhala NC, Many WJ, Saag MS, Johnson VA "Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: a report of 12 cases." Clin Infect Dis 33 (2001): 1914-21
  22. Kronenberg A, Riehle HM, Gunthard HF "Liver failure after long-term nucleoside antiretroviral therapy." Lancet 358 (2001): 759-601
View all 22 references
Major

Nrtis (Includes Zerit) ↔ Pancreatitis

Severe Potential Hazard, Low plausibility

Applies to: Alcoholism, Pancreatitis, Hyperlipidemia

The reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC), stavudine (d4T) and lamivudine (3TC), may cause pancreatitis. The incidence is generally low but is approximately 7% with ddI, and up to 15% in pediatric patients given 3TC. Patients with a history of or known risk factors for pancreatitis, such as alcohol abuse or hypertriglyceridemia, should be monitored closely during therapy with these agents. Therapy should be discontinued at the first signs or symptoms suggestive of pancreatitis (e.g., nausea, vomiting, abdominal pain, hyperamylasemia with dysglycemia, rising triglycerides, decreasing serum calcium), and preferably permanently discontinued if clinical pancreatitis develops.

References

  1. van Leeuwen R, Katlama C, Kitchen V, Boucher CA, Tubiana R, McBride M, Ingrand D, Weber J, Hill A, McDade H, et al "Evaluation of safety and efficacy of 3TC (lamivudine) in patients with asymptomatic or mildly symptomatic human immunodeficiency virus infection: a phase I/II study." J Infect Dis 171 (1995): 1166-71
  2. Dolin R, Lambert JS, Morse GD, et al "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  3. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
  4. van Leeuwen R, Lange JM, Hussey EK, Donn KH, Hall ST, Harker AJ, Jonker P, Danner SA "The safety and pharmacokinetics of a reverse transcriptase inhibitor, 3TC, in patients with HIV infection: a phase I study." AIDS 6 (1992): 1471-5
  5. Pike IM, Nicaise C "The didanosine Expanded Access Program: safety analysis." Clin Infect Dis 16 (1993): S63-8
  6. Yarchoan R, Mitsuya H, Pluda JM, et al "The National Cancer Institute phase I study of 2',3'-dideoxyinosine administration in adults with AIDS-related complex: analysis of activity and toxicity profiles." Rev Infect Dis 12 (1990): s522-33
  7. "Product Information. Epivir (lamivudine)." Glaxo Wellcome, Research Triangle Park, NC.
  8. Matthews SJ, Cersosimo RJ, Spivack ML "Zidovudine and other reverse transcriptase inhibitors in the management of human immunodeficiency virus-related disease." Pharmacotherapy 11 (1991): 419-49
  9. Shelton MJ, O'Donnell AM, Morse GD "Didanosine." Ann Pharmacother 26 (1992): 660-70
  10. Whittington R, Brogden RN "Zalcitabine: a review of its pharmacology and clinical potential in acquired immunodeficiency syndrome (AIDS)." Drugs 44 (1992): 656-83
  11. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  12. Moore RD, Fortgang I, Keruly J, Chaisson RE "Adverse events from drug therapy for human immunodeficiency virus disease." Am J Med 101 (1996): 34-40
  13. Grasela TH, Walawander CA, Beltangady M, Knupp CA, Martin RR, Dunkle LM, Barbhaiya RH, Pittman KA, Dolin R, Valentine FT, "Analysis of potential risk factors associated with the development of pancreatitis in phase i patients with AIDS or AIDS-related complex receiving didanosine." J Infect Dis 169 (1994): 1250-5
  14. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  15. Montaner JSG, Rachlis A, Beaulieu R, Gill J, Schlech W, Phillips P, Auclair C, Boulerice F, Schindzielorz A, Smaldone L, Wainber "Safety profile of didanosine among patients with advanced HIV disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program." J Acquir Immune Defic Syndr 7 (1994): 924-30
  16. Schindzielorz A, Pike I, Daniels M, Pacelli L, Smaldone L "Rates and risk factors for adverse events associated with didanosine in the expanded access program." Clin Infect Dis 19 (1994): 1076-83
  17. Bouvet E, Casalino E, Prevost MH, Vachon F "Fatal case of 2',3'-dideoxyinosine-associated pancreatitis." Lancet 336 (1990): 1515
  18. Maxson CJ, Greenfield SM, Turner JL "Acute pancreatitis as a common complication of 2',3'-dideoxyinosine therapy in the acquired immunodeficiency syndrome." Am J Gastroenterol 87 (1992): 708-13
View all 18 references
Major

Nrtis (Includes Zerit) ↔ Peripheral Neuropathy

Severe Potential Hazard, High plausibility

Applies to: Peripheral Neuropathy

The nucleoside reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC), and stavudine (d4T), may commonly cause dose-related peripheral neuropathy, particularly in patients with advanced HIV disease. Usually, the neuropathy resolves slowly following prompt discontinuation of therapy, but it can be irreversible. These agents should be administered cautiously to patients with a history of neuropathy and avoided in patients with existing polyneuropathy. Therapy may be reinstituted following resolution of symptoms in patients who have previously experienced neuropathy with these drugs, but reduced dosages are recommended.

References

  1. Whittington R, Brogden RN "Zalcitabine: a review of its pharmacology and clinical potential in acquired immunodeficiency syndrome (AIDS)." Drugs 44 (1992): 656-83
  2. Moore RD, Fortgang I, Keruly J, Chaisson RE "Adverse events from drug therapy for human immunodeficiency virus disease." Am J Med 101 (1996): 34-40
  3. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  4. LeLacheur SF, Simon GL "Exacerbation of dideoxycytidine-induced neuropathy with dideoxyinosine." J Acquir Immune Defic Syndr 4 (1991): 538-9
  5. Dubinsky RM, Yarchoan R, Dalakas M, Broder S "Reversible axonal neuropathy from the treatment of AIDS and related disorders with 2',3'-dideoxycytidine (ddC)." Muscle Nerve 12 (1989): 856-60
  6. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
  7. Martinez OP, French MA "Acoustic neuropathy associated with zalcitabine-induced peripheral neuropathy." AIDS 7 (1993): 901-2
  8. Broder S, Yarchoan R "Dideoxycytidine: current clinical experience and future prospects." Am J Med 88 (1990): s31-3
  9. Fichtenbaum CJ, Clifford DB, Powderly WG "Risk factors for dideoxynucleoside-induced toxic neuropathy in patients with the human immunodeficiency virus infection." J Acquir Immune Defic Syndr Hum Retrovirol 10 (1995): 169-74
  10. Matthews SJ, Cersosimo RJ, Spivack ML "Zidovudine and other reverse transcriptase inhibitors in the management of human immunodeficiency virus-related disease." Pharmacotherapy 11 (1991): 419-49
  11. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  12. Dubinsky RM, Dalakas M, Yarchoan R, Broder S "Follow-up of neuropathy from 2'3'-dideoxycytidine." Lancet 1 (1988): 832
View all 12 references
Major

Nrtis (Includes Zerit) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Patients with clinically significant renal impairment may be at greater risk for toxicities and adverse effects from nucleoside reverse transcriptase inhibitors (NRTIs) due to decreased drug clearance. Dosage adjustments are recommended. In addition, these patients should be monitored closely during NRTI therapy, and dosages adjusted further if necessary.

References

  1. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Retrovir (zidovudine)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Epivir (lamivudine)." Glaxo Wellcome, Research Triangle Park, NC.
View all 4 references

Zerit (stavudine) drug Interactions

There are 129 drug interactions with Zerit (stavudine)

Zerit (stavudine) alcohol/food Interactions

There is 1 alcohol/food interaction with Zerit (stavudine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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