stavudine
(d4T)

Drug type:

• Family of "NRTI" (Nucleoside analog reverse transcriptase inhibitor antiretroviral agent)

Important prescribing information:

• Stavudine may cause peripheral neuropathy, particularly in combination with didanosine (ddl).
• Never combine stavudine with zidovudine (ZDV) as the two are antagonists.
• Association of DDI with D4T increase risk of neuro problems
• In a poor hospice of dying patient it is not so important to know that as with all "NRTI", stavudine has been associated with lactic acidosis and hepatic steatosis, as well as other side effects attributed to mitochondrial toxicity. Lactic acidosis is rare, but should be considered in patients presenting with unexplained fatigue, abdominal pain, nausea, vomiting, and/or unexplained shortness of breath. It start a few months after intiating treatment.
• If you can choice between AZT and D4T in your coctail, it is better to choice AZT since D4T can cause cosmetic changes in long use

Contraindications:

• Severe renal insufficiency
• Severe hepatic insufficiency
• History of previous intolerance
• Apparition after few meeks/months of symetrical paresia & paresthesia of legs...)

Usual dose:

• May be taken with or without food.
• For patients > 60 kg, one 40-mg pill twice daily
• For patients < 60 kg, one 30-mg pill twice daily.

Information for patients:

• D4T can cause cosmetic changes in long use (lipodystrophy)