stavudine (Zerit, d4T)
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Introduction
Tradename: Zerit.
Indications
- treatment of HIV1/AIDS
- intolerant to approved therapies
- significant clinical deterioration while receiving approved therapies
- approved therapies contraindicated
Dosage
- 40 mg PO BID, or
- 30 mg PO BID if < 60 kg
Tabs: 15, 20, 30, 40 mg. Powder for oral solution (flavored): 1 mg/mL (200 mL). Dose adjustment in renal failure:
| creatinine clearance | dose (>60kg) | dose (<60kg) |
|---|---|---|
| > 50 mL/min | 40 mg every 12 hours | 30 mg every 12 hours |
| 26-49 mL/min | 20 mg every 12 hours | 15 mg every 12 hours |
| 10-25 mL/min | 20 mg 1st every 24 hours | 15 mg every 24 hours |
Pharmacokinetics
elimination via liver
elimination via kidney
Adverse effects
- common (> 10%)
- less common (1-10%)
- other
- elevated transaminases
- rash
- syndrome of hepatic steatosis & lactic acidosis[5]
- lipodystrophy[6]
- dyslipidemia[6]
* peripheral neuropathy may be dose-limiting
Drug interactions
- do not use with zidovudine (AZT)[6]
Laboratory
Mechanism of action
- a thymidine analog.
- inhibits HIV reverse transcriptase
- d4T penetrates the blood brain barrier into the CSF
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 5.0 5.1 Journal Watch 20(17):137, 2000 Miller et al Ann Intern Med 133:192, 2000
- ↑ 6.0 6.1 6.2 6.3 Medical Knowledge Self Assessment Program (MKSAP) 14, 17. American College of Physicians, Philadelphia 2006, 2014