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Stavudine

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Stavudine, more commonly known as d4T, is one of our earliest nucleoside analogue (NRTI) drugs. It is still in use but no longer recommended as first-line therapy due to concerns about long-term toxicities, most significantly lipoatrophy (facial wasting).

Generic name: stavudine (d4T)
Pronunciation:STAV-oo-deen
Brand name:Zerit
Drug class:nucleoside analogue
Pregnancy safe?Not suitable for use in pregnancy. If you are pregnant or may become pregnant, you should not take this treatment.
Pediatric dosing?Available in doses suitable for children and/or young people.
Availability in Australia:
  • Available on the Pharmaceutical Benefits Scheme (PBS) through S100 prescribers.
  • This drug may be available through clinical trials in Australia.
  • You may be able to import this drug from overseas for your personal use.
Presentation:Capsule 20mg; capsule 30mg; capsule 40mg; powder for oral solution 1mg per ml.
What the treatment guidelines say:Stavudine is no longer recommended as first-line HIV therapy due to concerns about long-term toxicities including peripheral neuropathy and lipoatrophy. If you are currently taking stavudine you should continue to do so, however if you are concerned about these findings you should discuss them with your doctor.
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Like most anti-HIV drugs, stavudine must be taken in combination with other drugs to be completely effective. Commonly, stavudine is combined with one other nucleoside (NRTI) drug and either a protease inhibitor or non-nucleoside, although other combinations are sometimes used. Your doctor will advise you on the right combination of drugs to suit your circumstances.

Dosage

The usual adult dose of stavudine is one 40mg capsule taken twice a day for people over 60kg body weight, or one 30mg capsule taken twice a day for people under 60kg. Alternative doses for children are also available.

Regardless of what you read on this website or elsewhere, you should always take your medications according to your doctor's instructions. If you're unsure, speak to your doctor or pharmacist.

With or without food?

Stavudine may be taken with or without food.

Side effects

All drugs can produce side effects in some people. These may be mild, moderate or severe, so you should be aware of potential side effects before starting any drug, and speak to your doctor if you experience side effects that concern you.

  • Common side effects may include nausea (upset stomach, feeling sick to the stomach), diarrhoea, vomiting, abdominal pain, fever, constipation, chills, headaches, listlessness, dehydration..
  • Less common side effects may include lipodystrophy, peripheral neuropathy, metabolic abnormalities.
  • Rare side effects may include pancreatitis, lactic acidosis, fatty liver.

    • It's unlikely you will experience all of these side effects, and you may not experience any side effects at all. Before starting any new drug, ask your doctor about side effects you might experience and discuss strategies for dealing with side effects if they do occur. If you experience any significant side effect you should continue taking your medicine and see your doctor as soon as possible.

Interactions with other drugs

d4T should not be combined with AZT. They are "antagonistic," which means that they do not work well together and can cause additional side effects. Zerit should not be combined with ribavirin - an oral medication used to treat hepatitis C. Ribavirin can affect the way Zerit is broken down by the body into its active form. This can make Zerit less effective against HIV. Methadone, a painkiller used to treat heroin addiction, can decrease Zerit levels in the bloodstream. Drug levels of methadone are not changed when combined with Zerit. There is no need to change the dose of either drug if they are used together. Combining Zerit with didanosine (ddI), another NRTI, may increase the risk of developing lactic acidosis and other side effects. This is especially true in HIV positive pregnant women who take both of these drugs together. This combinationm may increase the risk of developing peripheral neuropathy, a side effect caused by both drugs.
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Consumer Medical Information for stavudine (Zerit)43.83 KBbqczercp21007.pdfPDF

Getting spine: the nucleoside backbone

Positive Living article • Paul Kidd • 19 January 2006

Nucleoside analoguesA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different. are the backbone of successful anti-HIV treatments. This article examines some of the issues involved in selecting the best nucleoside backbone. read more »

Beyond the barbs

Positive Living article • Jim Arachne • 19 December 2004

Peripheral neuropathy (PN) is a debilitating treatment side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. and one of the common reasons for people stopping their anti-HIV medication. read more »

The power of one

Positive Living article • Paul Kidd • 15 December 2003

We all want simpler treatment regimens with fewer side effects and no meal restrictions, right? Well how does once-a-day treatment sound? As PAUL KIDD reports, it may be closer than you think. read more »

2001 European HIV conference, Athens

Story • Kirsty Machon • 28 October 2001

A report from the 8th European Conference on the ClinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. Aspects and Treatment of HIV Infection, held in Athens, Greece in October, 2001. read more »

The table below shows all the clinical trials in the database with the keyword stavudine (d4T).

Sorry, no clinical trials database entries were found that matched your request.

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This Treatments database entry was first published on 30 March 2009 — more than three years ago.

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