Drug reference

Stavudine

Antiretroviral

Also known as d4T

Antiretroviral

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

7 major

SEVERE in our sources

PREGNANCY

Manufacturer advises use only if potential benefit outweighs risk.

FDA category + note

Top interactionssee all 8 →

BexaroteneSevereDatabaseDDInter
DidanosineSevereDatabaseDDInter
LeflunomideSevereDatabaseDDInter
LomitapideSevereDatabaseDDInter

Mechanism

Stavudine is a nucleoside reverse transcriptase inhibitor (NRTI). It is a pyrimidine nucleoside analog that, upon intracellular phosphorylation, becomes an active metabolite. This active form competitively inhibits HIV reverse transcriptase and can be incorporated into the viral DNA chain, leading to premature chain termination and inhibition of viral replication.

Indications

HIV infection in combination with other antiretroviral drugs when no suitable alternative available and when prescribed for shortest period possibleHIV infection (in combination regimens)

Dosing

Adult: Adult (body-weight up to 60 kg): 30 mg every 12 hours, to be taken preferably at least 1 hour before food. Adult (body-weight 60 kg and above): 40 mg every 12 hours, to be taken preferably at least 1 hour before food.
Renal adjustment: Use half normal dose every 12 hours if eGFR 25–50 mL/minute/1.73 m2. Use half normal dose every 24 hours if eGFR less than 25 mL/minute/1.73 m2.

Pharmacokinetics

Half-life

1.5 hr

Contraindications

Excessive alcohol intake
History of pancreatitis
History of peripheral neuropathy
Lactic acidosis (especially when used in combination with didanosine)
Hepatomegaly
Hepatitis
Other risk factors for liver disease and hepatic steatosis (including obesity and alcohol abuse)

Side effects

Common

Abnormal dreamsDepressionDrowsinessDyspepsiaHyperlactacidaemiaLipoatrophyNerve disordersParaesthesiaPeripheral neuropathyThinking abnormalAnxietyAppetite decreasedArthralgiaEmotional lability

Serious