Meds and you

27 September 2013


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


(Also known as ddC) Zalcitabine is the active ingredient of Hivid Tablets (Nappi Code: 797189-009, 797170-009, 876062-001).

General information
Zalcitabine 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 zalcitabine 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 zalcitabine 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 zalcitabine 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.

Zalcitabine 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 zalcitabine 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. Zalcitabine targets and inhibits this enzyme, thus preventing the spread of HIV.

Fast facts

Drug schedule: schedule 4
Available as: alcitabine is available as tablets
What does it do? Zalcitabine is an anti-viral drug.
Overdose risk: medium
Dependence risk: low
Is Zalcitabine available as a generic? no
Is Zalcitabine available on prescription only? yes

User information

Dietary advice: zalcitabine should best be taken on an empty stomach as food may delay the absorption of this drug
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 have been diagnosed with a condition that affects your heart muscle
  • you have a history of heart failure
  • 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 zalcitabine is also present and transmitted in breast milk.
Porphyria: this medication is safe 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 13 years.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness. Avoid such activities until you know how this medication affects you.
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
mouth ulcers
sore throat
weight loss
skin rash
chest pain
painful swallowing
rapid/shallow breathing
severe abdominal pain


Food interactions


Antacids take at least 2 hours apart
Didanosine increased risk of peripheral nerve damage
Isoniazid reduced effect of isoniazid
Pentamidine risk of fatal pancreatic inflammation
Probenecid, Amphoterecin B, Foscarnet, Cimetidine increased risk of zalcitabine toxicity
Stavudine, dapsone, disulfiram, ethionamide, isoniazid, lithium, phenytoin increased risk of peripheral nerve damage
Alcohol, azathioprine, methyldopa increased risk of pancreatic inflammation

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

Disease interactions
Contact your doctor if you have a liver or kidney disease, if you have severe inflammation of the pancreas, if you have heart disease, 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: oral, 0.75 mg 3 times a day


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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