II. Mechanism

III. Pharmacokinetics

  1. Well absorbed with 83% bioavailability

IV. Efficacy

  1. Increases CD4 Counts and suppresses HIV p24 antigenemia
    1. Doses of 0.1-2.0 mg/day
    2. Dose related response (better at higher doses)
  2. Very little resistance currently

V. Dosing

  1. Stavudine 40 mg PO bid ($224/month)

VI. Toxicity

  1. Less Bone Marrow toxicity than Zidovudine (AZT)

VII. Adverse Effects

  1. See nRTI for adverse effects attributed to the class
  2. Headache
  3. Nausea, Vomiting
  4. Asthenia, confusion
  5. Serum Aminotransferase elevation
  6. Creatine Kinase elevation
  7. Lipodystrophy
  8. Hyperlipidemia
  9. Glucose intollerance to Diabetes Mellitus
  10. Lactic Acidosis
    1. Potentially lethal
    2. Higher risk when used in combination with Didanosine
  11. Moderate painful sensory Peripheral Neuropathy
    1. Most common serious side effect (more than other nRTI agents)
    2. Dose related (may not recur if restart at lower dose)
  12. Pancreatitis and hyperamylasemia (rare)

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Cost: Medications

stavudine (on 10/21/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
STAVUDINE 40 MG CAPSULE Generic $0.95 each

Ontology: Stavudine (C0164662)

Definition (NCI_NCI-GLOSS) A drug that belongs to the family of drugs called nucleoside analogues. It is used to treat infection caused by viruses.
Definition (NCI) A nucleoside reverse transcriptase inhibitor analog of thymidine. Stavudine has been recommended to undergo phase-out management due to its long-term, irreversible side-effects.
Definition (CSP) nucleoside analog; used as an antiviral agent.
Definition (MSH) A dideoxynucleoside analog that inhibits reverse transcriptase and has in vitro activity against HIV.
Definition (PDQ) A synthetic nucleoside, analog of didehydro-3-deoxythymidine with potent antiretroviral activity. In vivo, stavudine is phosphorylated by cellular kinases to the active metabolite stavudine triphosphate; this metabolite inhibits the activity of HIV reverse transcriptase both by competing with the natural substrate deoxythymidine triphosphate and by incorporation into viral DNA causing a termination of DNA chain elongation (due to the lack the essential 3'-OH group). Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41064&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41064&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1428" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH D018119
SnomedCT 108690008, 386895008
LNC LP21315-4, MTHU013858
English D4T, Stavudine, 2',3'-Didehydro-2',3'-dideoxythmidine, 2',3'-Didehydro-3'-deoxythymidine, 2',3' Didehydro 3' deoxythymidine, Thymidine, 2',3'-didehydro-3'-deoxy-, 3'-Deoxy-2'-thymidinene, 1-(2,3-Dideoxy-beta-glycero-pent-2-enofuranosyl)thymine, stavudine, DIDEHYDRODEOXYTHYMIDINE 02 03 03, D A 004 T, Dideoxydidehydrothymidine, 2'3' didehydro 3' deoxythymidine, 2'3' didehydrodeoxythymidine, stavudine (medication), STAVUDINE, Stavudine [Chemical/Ingredient], d4t, Stavudine (product), Stavudine (substance), dideoxydidehydrothymidine, didehydrodeoxythymidine, d4T, Didehydrodeoxythymidine, STAVUDINE (d4T)
German 2,3-Didehydro-3-Desoxythymidin, DIDEHYDRODESOXYTHYMIDIN 02 03 03, D A 004 T, 2',3'-Didehydro-3'-Desoxythymidin, D4T, Stavudin
Swedish Stavudin
Czech stavudin
Finnish Stavudiini
Russian STAVADIN, STAVUDIN, DEGIDRODEZOKSITIMIDIN, 2',3'-DIDEGIDRO-3'-DEZOKSITIMIDIN, D4T, 2',3'-ДИДЕГИДРО-3'-ДЕЗОКСИТИМИДИН, ДЕГИДРОДЕЗОКСИТИМИДИН, СТАВАДИН, СТАВУДИН
Japanese サニルブジン, スタブジン, 2',3'-ジデヒドロ-3'-デオキシチミジン
Polish Stawudyna, D4T
Portuguese 2',3'-Didesidro-3'-desoxitimidina, D4T, Estavudina
Spanish estavudina (producto), estavudina (sustancia), estavudina, D4T, 2',3'-Didehidro-3'-desoxitimidina, Estavudina
French 2,3'-didehydro-3'-deoxythymidine, d4T, Stavudine
Italian Stavudina

Ontology: Zerit (C0701312)

Concepts Pharmacologic Substance (T121) , Nucleic Acid, Nucleoside, or Nucleotide (T114)
MSH D018119
German Zerit
English zerit, Zerit, Bristol-Myers Brand of Stavudine, Bristol-Myers Squibb Brand of Stavudine