Drug Information

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Brand Name
Common Name
stavudine (d4T)
How does this medication work? What will it do for me?

Stavudine, also known as d4T, belongs to the class of medications called antiretrovirals. It is used in combination with other antiretroviral medications to treat the infection caused by the human immunodeficiency virus (HIV). HIV is the virus responsible for acquired immune deficiency syndrome (AIDS).

Stavudine is one of a class of antiretrovirals called nucleoside analog reverse transcriptase inhibitors (NRTIs). Reverse transcriptase is a part of HIV required to infect cells and make more virus. Stavudine prevents reverse transcriptase from working properly. HIV infection destroys CD4 (T) cells, which are important to the immune system. The immune system helps fight infections. Stavudine helps the body maintain its supply of CD4 cells.

Stavudine does not cure HIV infection or AIDS and does not prevent it from being spread to others but does help to slow down the destruction of the immune system. This may help delay the development of the problems associated with HIV disease and AIDS.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended adult dose of stavudine is based on body weight. Those weighing less than 60 kg usually take a dose of 30 mg every 12 hours, while those weighing 60 kg or more take a dose of 40 mg every 12 hours. Adults who have impaired kidney function require lower doses. Children's doses are also based on body weight as calculated by their doctor. Stavudine can be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication every 12 hours exactly as prescribed by your doctor. The effectiveness of the medication depends on the right amount of stavudine staying in the bloodstream. If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

What form(s) does this medication come in?

Stavudine is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

Who should NOT take this medication?

Do not take this medication if you are allergic to stavudine or to any of the ingredients of the medication.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • chills
  • cough
  • diarrhea
  • difficulty sleeping
  • dizziness
  • dry skin
  • fever
  • gas
  • headache
  • lack of strength or energy
  • loss of appetite
  • nausea
  • skin rash
  • sore throat
  • stomach pain (mild)
  • vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • joint pain
  • muscle pain
  • signs of liver toxicity (e.g., yellowing of skin and eyes, dark urine, light-coloured bowel movements)
  • stomach pain (severe)
  • symptoms of depression (e.g., losing interest in your usual activities, feeling sad)
  • symptoms of pancreatitis (upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
  • tingling, burning, numbness, or pain in the hands or feet
  • unusual tiredness or weakness
  • weight loss

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of lactic acidosis (e.g., dizziness, fatigue, unusual muscle pain, nausea, vomiting, stomach pain, feeling cold in legs and arms, fast heartbeat)
  • signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting , sweating, fast heartbeat, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Fat redistribution: This medication may change how fat is distributed on your body. With long-term use, fat may accumulate on the stomach, back, and breasts and be reduced on the arm, legs, and face. Notify your doctor if you start developing any changes in your body's appearance.

Immune system: When you start taking HIV medications such as stavudine, your immune system may get stronger and start to fight other infections that have been hidden in your body (e.g., pneumonia, herpes, or tuberculosis). Contact your doctor if you develop any new symptoms after starting HIV medications such as stavudine.

Kidney disease: If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lactic acidosis and enlarged liver: This medication can cause a rare but serious condition called lactic acidosis (buildup of lactic acid), together with an enlarged fatty liver. Your doctor will periodically monitor you and perform laboratory tests to check your liver function. Seek immediate medical attention if you notice any symptoms of this condition, such as:

  • dizziness
  • feeling cold
  • irregular heartbeat
  • lightheadedness
  • nausea
  • stomach pain
  • tiredness
  • vomiting
  • weakness

Liver problems: This medication can cause liver problems. Your doctor may monitor your liver function while you are taking this medication, especially if you have risk factors for liver problems. Tell your doctor immediately about any signs of liver problems, such as:

  • dark urine
  • diarrhea
  • loss of appetite
  • nausea
  • pale stools
  • vomiting
  • weight loss
  • yellowing of the skin or whites of the eyes

Pancreatitis: This medication may cause inflammation of the pancreas (pancreatitis). If you have previously had pancreatitis or are at risk for developing it, if you have gallstones, or if you regularly drink alcohol, you are at increased risk of developing pancreatitis when taking stavudine and should be closely monitored by your doctor while taking this medication. Contact your doctor if you develop signs of pancreatitis, such as:

  • back pain
  • chills
  • fever
  • nausea
  • rapid heartbeat
  • swollen abdomen
  • upper left abdominal pain

Peripheral neuropathy: Stavudine may cause a rare but serious nerve disorder called peripheral neuropathy. This is more likely to occur in people who have had it previously, people who are taking medications that affect the nerves (e.g., didanosine), and people with advanced HIV disease, but it can occur at any disease stage. Tell your doctor immediately if you experience tingling, burning, numbness, or pain in the hands or feet.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known whether stavudine passes into breast milk. Because HIV can be transmitted by breast milk, women who have HIV should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children less than 3 months old.

What other drugs could interact with this medication?

There may be an interaction between stavudine and any of the following:

  • didanosine
  • doxorubicin
  • hydroxyurea
  • orlistat
  • ribavirin
  • zidovudine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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