Stavudine (Oral)

Stavudine is also marketed as the drug Zerit in some countries and is an antiviral medication available only from a doctor to treat human immunodeficiency

Overview

What is Stavudine?

Stavudine is an antiviral medication used to treat the infection known as HIV, which causes AIDS. Stavudine does not prevent people from getting the HIV infection or AIDS nor does it cure these conditions. It does, however, slow the HIV virus reproduction, delaying health issues that are associated with this condition and with AIDS.

Stavudine does not prevent patients from giving the HIV infection to others, so the usual precautions for preventing the spread of this disease should be taken.

Stavudine is a medication that is taken orally in the form of a capsule. It can also be prescribed in powder format to be taken as a solution or a suspension.

How does Stavudine work?

Stavudine is classed among drugs known as reverse transcriptase inhibitors. When a patient is infected with HIV, the virus lives within the body's own cells and multiplies itself. The newly multiplied virus cells are spread through the body, released to infect other cells. Because of this action, previously unaffected parts of the body are infected quickly and those cells start multiplying and so on. The HIV virus manufactures new DNA for each virus and to do so it uses an enzyme known as reverse transcriptase.

Stavudine, once in the body, is converted to stavudine triphosphate, which is similar to the chemical that HIV uses to manufacture new DNA in order to multiply. Instead of using its own reverse transcriptase, HIV is fooled into using stavudine triphosphate, which doesn't act in the same way and slows the reproduction process of the virus. Existing HIV virus cells aren't killed by Stavudine so it is not a cure; it is used to slow the progress of the virus and prevent full blown infections.

What is HIV?

HIV, or the human immunodeficiency virus, is the virus that causes AIDS, acquired immunodeficiency syndrome, over time. AIDS is a condition in which the immune system fails and allows life-threatening infections and cancers to take over and eventually kill the patient. Infection with HIV occurs with the transfer of bodily fluids including blood, semen, vaginal fluids and breast milk.

HIV infects vital CD4 T cells, among others, leading to low levels of these immune fighting cells, which leads to the body becoming progressively more susceptible to infections. Many HIV infected people are unaware that they have the virus. Early symptoms include:

  • Fever
  • Malaise
  • Pain and swelling in joints
  • Loss of appetite
  • Rash
  • Pain in muscles
  • Fever and rash
  • Inflammation in the back of the throat
  • Oral ulcers
  • Weight loss

Having any of these symptoms should prompt you to get tested, the earlier you are treated the better your prognosis. Additionally, if you are aware that you have the virus, you can take precautions to stop it from spreading to others.

Conditions treated

  • HIV human immunodeficiency virus

Type of medicine

  • Antivirus

Side effects

Stavudine directly affects the functions performed by the body's cells as it treats the HIV virus in patients who have been prescribed this treatment. While Stavudine affects the cancer cells, it may also create the following side effects:

  • Stomach pain, discomfort
  • Stool that is tarry or black
  • Bleeding in gums
  • Bloated feeling
  • Urine or stools with blood
  • Vision that is blurred
  • Dark urine
  • Loss of appetite
  • Diarrhea
  • Paralysis
  • Mouth dryness
  • Flushed skin
  • Breath odor that is like fruit
  • General discomfort
  • Hungry or thirsty
  • More urine frequency
  • Upset stomach
  • Very pale stools
  • No appetite
  • Fainting
  • Stiff, cramped, painful muscles
  • Difficult to urinate or painful
  • Side pain that radiates to the back
  • Pale, wan appearance
  • Tiny red spots appearing on skin
  • Trembling
  • Throat soreness
  • Glands that are swollen
  • Weight loss that can't be explained
  • Mouth ulcers with the appearance of white sores
  • Unexpected bruising or bleeding
  • Eyes or skin with yellowed appearance

If you experience any of these side effects, contact your health care provider immediately to prevent them from becoming worse or causing long-term health issues.

Stavudine can also cause the following mild side effects that don't typically require medical attention. If you contact your physician, their office can give you information on how to ease these symptoms:

  • No appetite
  • Headache
  • Insomnia
  • No energy
  • Mild pains in the stomach
  • Loss of weight
  • Unusual weight gain in isolated areas of the body

Side effects that seem severe or prolonged in duration should be reported to your doctor's office immediately.

Dosage

Your doctor has determined your prescription of Stavudine based on your particular health condition, age, weight, symptoms and other factors. Do not change the dosage, frequency or duration of your drug treatment from what your doctor has prescribed or you risk affecting the effectiveness of the Stavudine treatment as well as possibly causing yourself life-threatening health issues.

Take Stavudine for the entire duration prescribed even if you begin to feel better. Do not allow yourself to run out of medicine; contact your health care provider if you are running low. Stavudine is most effective when a consistent amount is in your body, so do not skip doses and plan your medication schedule carefully, assisted by your health care provider if necessary.

If you are prescribed capsules, swallow them without chewing, crushing or dissolving them in any liquids. Stavudine may be prescribed in an oral liquid, which should be shaken before use and carefully measured with the cup provided with your prescription. Review the leaflet information that comes with a Stavudine prescription entirely and follow your doctor's prescribed dosage.

Patients will be prescribed a treatment of Stavudine based on their doctor's recommendation for their personal health condition. Below is the average dosage information; be aware that yours may be different and that you should follow your doctor's prescription.

For capsules or oral solution forms of Stavudine, adults and teenagers who weigh at least 60 kilograms are typically prescribed 40 milligrams to be taken twice daily. Adults and teenagers under 60 kilograms will be prescribed a 30 milligram dose twice daily. These doses may be adjusted by your physician over time.

Children who weigh 30 kilograms and above will typically be prescribed 30 milligrams to be taken twice per day; children and infants smaller than this will have their dosage adjusted according to their body weight and medical condition. On average, a body weight based dosage will be 1 milligram per kilogram of body weight twice daily.

Infants who are up to 13 days old will have their dosage based on body weight, which is typically 0.5 milligrams per kilogram of weight twice daily.

Capsules of Stavudine prescription are available in 15, 20, 30 and 40 milligram sizes while the powder to make the oral solution is typically 1 milligram per milliliter of liquid.

Interactions

It is of critical importance that you disclose your full medical history as well as details of any drugs you are currently taking or have taken in the recent past before you begin a course of treatment with Stavudine or any other drug. Be sure to include all prescription as well as non-prescription medications you may be taking and details of any herbal, vitamin, or holistic treatments or supplements you are currently taking or have taken in the past.

Any unusual reactions you've had to Stavudine or other drugs that could be allergy related should be communicated to your doctor before you begin treatment with this medication. Report any allergies you have experienced to animals, artificial colors, preservatives or foods to your health care provider.

No data has shown any less effectiveness or increased risks with regard to pediatric patients who have been treated with Stavudine. Additionally, geriatric patients have not shown any other adverse effects other than kidney diseases contracted with relation to their age that require an adjustment to the dosage amount of Stavudine.

Stavudine is recommended for women who are pregnant, as there isn't enough information to determine if a risk to the fetus is present with treatment by this drug. Breastfeeding women should consult their health care providers on the risks of using this drug and passing it on to their infants.

Certain drugs will affect the use of Stavudine by changing the way it works in the body or making it unsafe when used in combination. The following drugs are known to cause various issues when used with Stavudine:

  • Didanosine
  • Orlistat
  • Doxorubicin Hydrochloride Liposome
  • Hydroxyurea
  • Doxorubicin
  • Zidovudine
  • Ribavirin

Use of Methadone while being treated with Stavudine may increase health risks, but may be a necessary treatment. Your physician will consult with you to decide what the best route of treatment is for your health situation.

Other medical problems may affect the effectiveness and safety of a course of treatment with Stavudine. If you have any of the following conditions, make sure your health care provider is informed:

  • History of alcohol abuse
  • Active alcohol abuse
  • Gallstones including past occurrence
  • Hepatitis
  • Liver conditions
  • Overweight and considered obese
  • Inflamed pancreas
  • Pancreatitis
  • Nerve disorders
  • Long term use of HIV medications
  • Diabetes
  • Disease of the kidneys

Treatment with a course of Stavudine in combination with some of these conditions could increase the effects of the drug due to slow removal from the body or make them worse. Use of Stavudine with these conditions should be under close cautionary advice from a doctor.

This is not a complete list; Stavudine may interact with other drugs, so it is recommended that you discuss any other courses of treatment you are on with your health care provider prior to treatment with Stavudine.

Warnings

Your doctor will check the progress of your condition on a regular basis while you are being given a course of treatment that includes Stavudine. Blood tests will be part of these progress checks, which will require office visits.

It is important not to change your dosage of Stavudine and not to skip or stop doses during the duration of treatment without the express permission of your health care provider.

Use of Stavudine is linked to two rare reactions that are serious in nature. One is a condition known as lactic acidosis and the other is toxic liver. Lactic acidosis is a condition where the blood contains too much acid. Toxic liver includes an enlargement of the liver. Being female, obese or on a long-term treatment with anti-HIV drugs are all risk factors for these two conditions when you use this drug. If you have the following symptoms, stop taking Stavudine and contact your health care provider as soon as possible:

  • Dark urine
  • Diarrhea
  • Uncomfortable feeling
  • Cramps
  • Low appetite
  • Stools that are light in color
  • Weakness
  • Fatigue
  • Cramps, pain in muscles
  • Nausea
  • Difficulty with breathing
  • Yellow skin or whites of the eyes
  • Vomiting

Stavudine has also been known to cause a condition called peripheral neuropathy. This condition can be detected if you have numbness, tingling or pain in legs, arms, feet or hands while taking Stavudine. You may also experience a rash, chills, pain in the abdomen, insomnia, or a loss of weight that is unexplained. If you exhibit these symptoms, stop taking this medication and contact your doctor as soon as possible.

You may be diagnosed with pancreatitis while you are being treated with Stavudine. Severe stomach cramps, constipation, nausea, chills, fever, faintness or vomiting should be reported to your physician immediately.

Stavudine will cause body fat to accumulate in areas such as around the chest, stomach, face, back or neck, which will cause you to lose fat elsewhere in your body.

Your body, experiencing a surge in immune system strength because of treatment with Stavudine, may exhibit new symptoms of hidden infections such as pneumonia or even tuberculosis. Your doctor should be told about any unusual symptoms of other infections right away.

It is best to avoid drinking beverages containing alcohol while taking Stavudine for the best results of the treatment. Do not combine Stavudine with any other drugs including herbal or vitamin supplements without checking with your physician first.

Storage

To properly store your capsules of Stavudine, keep it at room temperature and away from sources of heat or light and out of moist environments such as the bathroom. Do not allow Stavudine to freeze. Keep this medication out of sight and reach of children and pets. Stavudine is best kept in the original, closed container.

Liquid solutions of Stavudine are best kept in the refrigerator and only last 30 days before expiration. To discard unused or expired medications, contact your physician or pharmacist to receive instructions on how to properly dispose of this medication. Community donation programs are available for some medications that are properly stored and are still within their date of safety. Your physician or pharmacist will be able to advise you of these donation programs.

Summary

Stavudine, also known as Zerit, is prescribed by doctors for treatment of the infection known as HIV. Stavudine works by directly affecting how HIV infected cells multiply within the body, effectively stopping the reproduction of these cells by fooling the DNA enzyme. While this slows down the virus and thus lessens the side effects of HIV, it does not cure the virus or prevent the patient from contracting it. Stavudine is also not effective in stopping patients from spreading the HIV virus to others.

Stavudine can be used in infants, children and adults and is dosed based on medical condition, age and weight. Stavudine works best when allowed to become present in a steady manner in the body, so skipping doses is not advised. Health care professionals will typically prescribe a treatment schedule, which is the best way to insure the drug is effectively taken. Review all information that comes with your prescription of Stavudine and follow your doctor's prescribed dosage amounts and schedule closely.

Stavudine can cause serious health problems known as lactic acidosis, which is a high level of acid in the blood, as well as liver toxicity including enlargement of the liver. Females, people who suffer from obesity or have been in treatment with anti-HIV medication for a long period of time are more at risk for these conditions. Any conditions including abdominal, urine, stool or fatigue symptoms of any kind should be reported to your health care provider immediately and you should stop taking Stavudine.

Peripheral neuropathy, including symptoms of burning, tingling or pain in the limbs, feet or hands should be reported to your physician right away and use of Stavudine should be stopped immediately to avoid nerve damage.

Store Stavudine capsules at room temperature, out of light and heat sources, away from moisture and sources of extreme cold. Keep the medication in the original packaging and store it out of sight and reach of children and pets. Liquid Stavudine solutions should be kept refrigerated. When looking to dispose of unused medication, contact your physician or pharmacist for information on community donation programs or safe disposal practices.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018