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stavudine

Generic Name: stavudine (STA vue deen)
Brand Name: Zerit, Zerit XR

What is stavudine?

Stavudine is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in your body.

Stavudine is used to treat HIV, the virus that can cause acquired immunodeficiency syndrome (AIDS). Stavudine is not a cure for HIV or AIDS.

Stavudine may also be used for purposes not listed in this medication guide.

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

Do not use this medicine if you have ever had a severe allergic reaction to any medicine that contains zidovudine.

This medicine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Stavudine can also cause serious or life-threatening effects on your liver or pancreas. Call your doctor at once if you have: stomach pain or swelling, fever, nausea, vomiting, easy bruising or bleeding, loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes).

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

You should not take stavudine if you are allergic to it.

Do not take this medicine with any other medicine that contains zidovudine or stavudine, including: Combivir, Trizivir, or Retrovir.

Some people taking stavudine develop a serious condition called lactic acidosis. This may be more likely in women, in people who are overweight or have liver disease, and in people who have taken HIV/AIDS medication for a long time. Talk with your doctor about your risk.

Stavudine can also cause severe or life-threatening effects on your liver or pancreas. Tell your doctor if you have liver disease or a history of pancreatitis.

To make sure stavudine is safe for you, tell your doctor if you have ever had:

  • kidney disease;

  • liver disease;

  • gallstones;

  • numbness, tingling, or burning pain in your hands or feet;

  • problems with your pancreas; or

  • if you drink large amounts of alcohol.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of stavudine on the baby.

Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How should I take stavudine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Stavudine is usually given once every 12 hours. Take your doses at regular intervals to keep a steady amount of the drug in your body at all times. You may take stavudine with or without food.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.

Tell your doctor if you have any changes in weight. Stavudine doses are based on weight (especially in children and teenagers), and any changes may affect the dose.

While using stavudine, you may need frequent blood tests. Your liver function may also need to be checked.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store stavudine capsules at room temperature away from moisture and heat. Keep the bottle tightly closed.

Store the liquid medicine in the refrigerator, do not freeze. Throw away any unused liquid after 30 days.

Throw away any unused or expired stavudine in a closed container or sealed bag. You may also ask your pharmacist where to locate a community pharmaceutical take-back disposal program.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking stavudine?

Taking this medicine will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Avoid drinking alcohol. It may increase your risk of pancreas or liver damage while you are taking stavudine.

Stavudine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Early symptoms of lactic acidosis may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Call your doctor at once if you have:

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

  • weakness in your legs, feet, arms, or hands;

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

  • swelling around your midsection, upper stomach pain, unusual tiredness, loss of appetite, dark urine, easy bruising or bleeding; clay-colored stools, jaundice (yellowing of the skin or eyes);

  • numbness, tingling, or burning pain in your hands or feet; or

  • liver problems--loss of appetite, upper stomach pain, tiredness, easy bruising or bleeding, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Stavudine may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works. Symptoms may occur weeks or months after you start treatment with stavudine. Tell your doctor if you have:

  • signs of a new infection--fever, night sweats, swollen glands, mouth sores, diarrhea, stomach pain, weight loss;

  • chest pain (especially when you breathe), dry cough, wheezing, feeling short of breath;

  • cold sores, sores on your genital or anal area;

  • rapid heart rate, feeling anxious or irritable, weakness or prickly feeling, problems with balance or eye movement;

  • trouble speaking or swallowing, severe lower back pain, loss of bladder or bowel control; or

  • swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence, loss of interest in sex.

Common side effects may include:

  • headache;

  • nausea, vomiting, diarrhea; or

  • rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Side Effects (complete list)

Stavudine dosing information

Usual Adult Dose for HIV Infection:

Less than 60 kg: 30 mg orally every 12 hours
At least 60 kg: 40 mg orally every 12 hours

Comments:
-Some experts (including the WHO) have recommended a maximum dose of 30 mg orally twice a day, regardless of weight.

Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection

Usual Adult Dose for Nonoccupational Exposure:

US CDC Recommendations:
-Less than 60 kg: 30 mg orally every 12 hours
-At least 60 kg: 40 mg orally every 12 hours
Duration of therapy: 28 days

Comments:
-Only with expert consultation, as part of an alternative regimen for use as nonoccupational postexposure prophylaxis of HIV infection
-Prophylaxis should be started as soon as possible, within 72 hours of exposure.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Occupational Exposure:

US Public Health Service Working Group Recommendations:
-Less than 60 kg: 30 mg orally twice a day
-At least 60 kg: 40 mg orally twice a day
Duration of therapy: 28 days, if tolerated

Comments:
-Only with expert consultation, as part of an alternative regimen for use as HIV postexposure prophylaxis
-Prophylaxis should be started as soon as possible, preferably within hours after exposure.
-The optimal duration of prophylaxis is unknown and may differ based on institution protocol.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for HIV Infection:

Birth to 13 days: 0.5 mg/kg orally every 12 hours

14 days or older:
Less than 30 kg: 1 mg/kg orally every 12 hours
30 to less than 60 kg: 30 mg orally every 12 hours
At least 60 kg: 40 mg orally every 12 hours

Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection

Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV Recommendations:
-Neonates/infants (birth to 13 days): 0.5 mg/kg orally twice a day
-Pediatrics (14 days or older, weighing less than 30 kg): 1 mg/kg orally twice a day
-Adolescents (at least 30 kg): 30 mg orally twice a day

Comments:
-This drug is not recommended due to higher risk of side effects associated with mitochondrial toxicity and higher rate of lipoatrophy than other NRTIs.
-Current guidelines should be consulted for additional information.

What other drugs will affect stavudine?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • didanosine;

  • zidovudine or AZT;

  • doxorubicin;

  • hydroxyurea;

  • interferon-alfa; or

  • ribavirin.

This list is not complete. Other drugs may interact with stavudine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about stavudine.
  • 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: 11.01.

Date modified: December 03, 2017
Last reviewed: August 28, 2017

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