Meds and you

30 September 2013


Stavudine is an antiretroviral. Antiretrovirals are drugs that suppress the activity or replication of retroviruses such as HIV.


(Also known as d4T)

Stavudine is the active ingredient of Aspen-Stavudine Capsules (Nappi Code: 704885-001, 701172-001, 701174-001, 701175-001), Zerit Capsules (Nappi Code: 837458-005, 841323-003, 837407-001) & Zerit Oral Solution (Nappi Code: 846074-001).

General information
Stavudine is an antiretroviral. Antiretrovirals are drugs that suppress the activity or replication of retroviruses such as HIV. This specific antiviral is classified as a nucleoside reverse transcriptase inhibitor, meaning that it blocks an enzyme which is essential for the retrovirus to multiply.

In South Africa stavudine is registered for the treatment of infection with the human immunodeficiency virus (HIV), often in combination with other antiretroviral drugs.

If not treated, HIV will advance to weaken the body's immune system, gradually chipping away to create grounds for other infections which the body will find more and more difficult to protect itself against. HIV develops into acquired immune deficiency syndrome (AIDS) when your immune system has been severely weakened.

For stavudine to be effective it has to be taken regularly. By skipping even a few doses the risk for treatment failure increases substantially. Try to ensure that you take all your doses, and at the correct time.

It should be understood that stavudine is not a cure for HIV or AIDS, but is one of a variety of drugs that only restricts the advance of the virus, keeping the immune system up-and-running. It is used in combination with other antiretroviral drugs and should not be prescribed on its own.

Stavudine does not reduce transmission of HIV; you can still infect another person with the virus, and the use of appropriate precautions to prevent spread to other persons is highly recommended.

How does stavudine work?
When HIV infects a human T cell, a type of white blood cell that plays a key role in the functioning of the immune system, viral genetic information in the form of RNA needs to be converted to DNA for the virus to have any effect. It makes use of an enzyme called reverse transcriptase to achieve this conversion. Stavudine targets and inhibits this enzyme, thus preventing the spread of HIV.

Fast facts

Drug schedule: schedule 4
Available as: stavudine is available as capsules and as a powder for oral solution.
What does it do? Stavudine is an anti-viral drug.
Overdose risk: medium
Dependence risk: low
Is Stavudine available as a generic? yes
Is Stavudine available on prescription only? yes

User information

Dietary advice: stavudine should best be taken on an empty stomach.
Stopping this medicine: do not stop taking this drug without consulting your doctor.
Prolonged use: side-effects may develop with long-term use; frequent blood tests may be required with prolonged therapy to determine liver function. Damage to the nerves supplying the arms and legs is also frequent and regular tests are needed.

Special precautions
Consult your doctor before using this drug if:

  • you have known liver or kidney problems.

  • you have or had severe inflammation of the pancreas

  • you have been diagnosed with a disease affecting the nerves of the extremities (arms and legs)

  • you have a history of alcohol abuse

  • you are taking other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. Not only can HIV infection be passed to your baby through breast milk, but stavudine is also present and transmitted in breast milk.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
The elderly: caution is advised in the elderly as side effects may be more severe.
Infants and children: this medication is not intended for use in children under the age of 6 months.
Driving and hazardous work: no special precautions need to be taken.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Consult your doctor

Only if severe
In all cases
numbness, tingling, burning or pain in the hands or feet





loss of appetite


muscle/joint pain




abnormal enlargement of breasts in men






skin rash




pelvic/back pain


facial swelling


visual disturbances


severe abdominal pain




Food interactions

acyclovir risk of stavudine toxicity
doxrubicin, zidovudine reduced effect of stavudine
dapsone, didanosine, ethambutol, isoniazid increased risk of nerve damage
alcohol, valproic acid increased risk of pancreatic inflammation

Many other drugs may interact with stavudine. It is important to consult your doctor or pharmacist before combining any drug with stavudine.

Disease interactions
Contact your doctor if you have a liver or kidney disease, if you have severe inflammation of the pancreas, if you have been diagnosed with a disease affecting the nerves of the extremities (arms and legs) or if you have a history of alcohol abuse.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults > 60 kg: oral, 80 mg/day in 2 divided doses Adults < 60 kg: oral, 60 mg/day in 2 divided doses

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

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