Stavudine
Mechanism :
Stavudine inhibits the activity of HIV-1 reverse transcriptase (RT) both by competing with the natural substrate dGTP and by its incorporation into viral DNA.
Indication :
- For the treatment of HIV infection.
Contraindications :
Hypersensitivity
Dosing :
<14 days:
0.5 mg/kg PO every 12 hours.
>14 days and <30 kg:
1 mg/kg/day PO every 12 hours.
30-60 kg:
30 mg PO every 12 hours.
>60 kg:
40 mg PO every 12 hours.
Adverse Effect :
Lactic acidosis, lipoatrophy, hepatomegaly and hepatic steatosis, pancreatitis, diarrhoea, abdominal pain, nausea, dyspepsia, rash, pruritus, fatigue and polyneuropathy.
Interaction :
Antiviral effect inhibited by zidovudine, doxorubicin and ribavirin. Avoid concurrent admin with drugs that cause pancreatitis (e.g. IV pentamidine) or peripheral neuropathy (e.g. metronidazole, isoniazid and vincristine).
Hydroxycarbamide and Didanosine: Increased risk of adverse effects such as hepatoxicity, peripheral neuropathy and pancreatitis.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 26-50 | <60 kg: 15 mg twice daily >60 kg: 20 mg twice daily |
| <25 | <60 kg: 15 mg daily >60 kg: 20 mg daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in GFR<25 mL/min |
| HD | Dialysed. Dose as in GFR<25 mL/min |
| HDF/High flux | Dialysed. Dose as in GFR<25 mL/min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=26–50 mL/min |
Hepatic Dose :
Dose adjustment may be required. Use with caution and monitor liver functions. If liver functions worsen, stop therapy.