Zerit (stavudine) is a human immunodeficiency virus (HIV-1) nucleoside reverse transcriptase inhibitor (NRTI) used for the treatment of HIV-1 infection in combination with other antiretroviral drugs. Zerit works by binding to HIV-1 reverse transcriptase and acting as a chain terminator during viral replication.
Dosing & Administration
Zerit is indicated for the treatment of HIV infection in adults and children of all ages, including neonates, as part of a combination drug regimen. Zerit comes in oral capsules and an oral powder for reconstitution as a liquid suspension. It may be taken with or without food. Dosage instructions and considerations are detailed in the package insert.
Zerit is contraindicated in those patients who have clinically significant hypersensitivity to stavudine or to any of the components of this product. The administration of Zerit with didanosine is contraindicated. Fatal and nonfatal pancreatitis have occurred when Zerit has been part of a combination regimen that included didanosine.
Zerit Side Effects
Most common side effects reported with this product include:
A complete list of potential adverse effects is provided in the package insert.
Treatment should be discontinued for patients when hepatic toxicity occurs and also for neurologic symptoms including motor weakness. Alternative antiretrovirals should be considered for patients who develop localized loss of body fat. Monitoring of symptoms should occur for patients who develop immune reconstitution syndrome.
Zerit is associated with a number of drug-drug interactions, especially with didanosine and hydroxyurea. Prescribers should familiarize themselves with the complete list of drug interactions provided in the package insert.
Pregnancy & Lactation
Fatal lactic acidosis has been reported in pregnant patients who received both didanosine and stavudine with other agents. There is a pregnancy exposure registry that monitors pregnancy outcomes in individuals exposed to ZERIT during pregnancy. The purpose of the registry is to collect health information about the patient and the baby.
Limited data shows that stavudine has been detected in human milk. No data are available about the effects of stavudine on the breastfed infant, or the effects on milk production. Breastfeeding is not recommended due to the potential for HIV-1 transmission to HIV negative infants and due to HIV positive infants developing viral resistance.
Adults treated with 12 to 24 times the recommended daily dosage have shown no acute toxicity. Stavudine can be removed by hemodialysis. Whether or not this product is eliminated by peritoneal dialysis has not been studied.
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