II. Mechanism
- Nucleoside Reverse Transcriptase Inhibitor
- Inhibits HIV replication
III. Pharmacokinetics
- Well absorbed (87% oral Bioavailability)
IV. Efficacy
- Combination treatment Zalcitabine and Zidovudine (AZT)
- Late HIV without prior Anti-Retroviral Therapy
- Large and sustained CD4 Count increase
- Improves survival in patients with late HIV disease
V. Dosing
- Zalcitabine 0.75 mg PO tid ($207/month)
VI. Adverse Effects
- See nRTI for adverse effects attributed to the class
- Common symptoms during the first several weeks
- Effects
- Maculovesicular cutaneous eruptions
- Mucosal Ulcers
- Fevers
- Symptoms often resolve without stopping medication
- Consider Symptomatic therapy
- Symptoms less frequent at a dose of 2.25 mg/day
- Effects
- Painful Sensorimotor leg Peripheral Neuropathy (10-25%)
- Major dose limiting toxicity
- Discontinue drug at first signs of Neuropathy!
- Symptoms usually resolve over a few weeks
- Pancreatitis (<1%)