Stavudine

Indications
 Oral
HIV infection
Adult: <60: 30 mg; ≥60 kg: 40 mg. Doses to be taken every 12 hr.
Child: From birth-13 days old: 500 mcg/kg; ≥14 days old and weighing <30 kg: 1 mg/kg; 30 kg-<60 kg: 30 mg; ≥60 kg: 40 mg. Doses to be taken every 12 hr.
CrCl (ml/min)Dosage Recommendation
26-50<60 kg: 15 mg; ≥60 kg: 20 mg. Doses to be taken every 12 hr.
<25<60 kg: 15 mg; ≥60 kg: 20 mg. Doses to be taken every 24 hr.


Special Populations: Reduce dose in patients with renal impairment: CrCl 25-60 mL/min: 20 mg every 12 hrs (patients weighing ≥60 kg body weight) or 15 mg every 12 hrs (patients weighing <60 kg body weight). CrCl <25 mL/min: 20 mg every 24 hrs (patients weighing ≥60 kg body weight) or 15 mg every 24 hrs (patients weighing <60 kg body weight).
Contraindications
 Hypersensitivity. Lactation.
Warnings / Precautions
 Hepatomegaly or other risk factors for liver disease. History of peripheral neuropathy and renal impairment. Pregnancy. Discontinue treatment if peripheral neuropathy develops; may resume treatment at half the previous dose if symptoms resolve upon drug withdrawal. Monitor for signs of pancreatitis. Discontinue treatment if there is a rapid increase in aminotransferase concentrations, progressive hepatomegaly or steatosis, or metabolic or lactic acidosis. Increased risk of severe and fatal hepatic adverse events in patients with chronic hepatitis B or C treated with combination antiretroviral therapy.
Adverse Reactions
 Headache, nausea, vomiting, asthenia, chest pain, influenza-like syndrome, insomnia, abdominal pain, anorexia, neutropenia, thrombocytopenia, arthralgia, myalgia, mood changes, dyspnoea, pharyngitis, skin rashes, pruritus.
Overdose Reactions
 Chronic overdosage may lead to peripheral neuropathy and hepatic toxicity.
Drug Interactions
 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). Increased risk of adverse effects such as hepatoxicity, peripheral neuropathy and pancreatitis if used with hydroxycarbamide and didanosine.
See Below for More stavudine Drug Interactions
Mechanism of Actions
 Stavudine is converted intracellularly to the active metabolite stavudine 5'-triphosphate which is then incorporated into the viral DNA by reverse transcriptase resulting in premature ending of the DNA chain elongation.
Absorption: Rapidly absorbed from the GI tract after oral admin, food may delay its absorption; peak plasma concentrations within 1 hr.
Distribution: Crosses the blood-brain barrier and negligible plasma protein binding.
Metabolism: Intracellular; converted to the active antiviral triphosphate.
Excretion: Urine (about 40%); 1.5 hr (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 25°C.
ATC Classification
 J05AF04 - stavudine ; Belongs to the class of nucleoside and nucleotide reverse transcriptase inhibitors. Used in the systemic treatment of viral infections.
Storage
 Oral: Store at 25°C.
Available As
  • Stavudine 10 mg
  • Stavudine 12 mg
  • Stavudine 30 mg
  • Stavudine 40 mg
  • Stavudine 6 mg

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