Stavudine (patient information)

# IMPORTANT WARNING:
Stavudine, when used alone or in combination with other antiviral medications, may cause serious and possibly deadly damage to the liver and pancreas and a life-threatening condition called lactic acidosis. Tell your doctor if you have or have ever had liver or pancreas disease or gallstones, and if you have taken medication to treat HIV for a long time. Also tell your doctor if you drink or have ever drunk large quantities of alcohol and if you are taking didanosine (Videx) or hydroxyurea (Droxia, Hydrea). Tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking stavudine, call your doctor.
If you experience any of the following symptoms, call your doctor immediately: upset stomach, vomiting, unusual or unexpected stomach pain, sudden weight loss, extreme weakness or tiredness, shortness of breath, fast breathing, weakness in arms or legs, and any sudden change in your general health. Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to stavudine.

# Why is this medication prescribed
Stavudine is used in combination with other antiviral medications to treat human immunodeficiency virus (HIV) infection in patients with or without acquired immunodeficiency syndrome (AIDS). Stavudine is in a class of antiviral medications called nucleoside analogue reverse transcriptase inhibitors (NRTIs). It works by slowing the spread of HIV in the body. Stavudine does not cure HIV and may not prevent you from developing HIV-related illnesses. Stavudine does not prevent the spread of HIV to other people.

# How should this medicine be used
Stavudine comes as a capsule and a solution (liquid) to take by mouth. It is usually taken twice a day (every 12 hours), with or without food and with plenty of water. To help you remember to take stavudine, take it at around the same time each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take stavudine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are giving the oral solution to a child, shake the bottle well before each use to mix the medication evenly. Use the measuring cup provided to measure the child's dose.
Stavudine controls HIV infection but does not cure it. Continue to take stavudine even if you feel well. Do not stop taking stavudine without talking to your doctor. If you miss doses or suddenly stop taking stavudine, your condition may become more difficult to treat.

# Other uses for this medicine
Stavudine is also sometimes used in combination with other medications to prevent HIV infection in health care workers or other people who were accidentally exposed to HIV. Talk to your doctor about the possible risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking stavudine:
- tell your doctor and pharmacist if you are allergic to stavudine or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking. Be sure to mention those listed in the IMPORTANT WARNING section and zidovudine (Retrovir, also an ingredient in the combination products Combivir and Trizivir). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
- tell your doctor if you have or have ever had kidney disease, diabetes (if you are taking stavudine solution), or peripheral neuropathy (a type of nerve damage that causes tingling, numbness, and pain in the hands and feet).
- tell your doctor if you are breast-feeding. You should not breastfeed if you are infected with HIV or if you are taking stavudine.
- you should know that stavudine may cause side effects that must be treated right away before they become serious. Children who are taking stavudine may not be able to tell you about the side effects they are feeling. If you are giving stavudine to a child, ask the child's doctor how you can tell if the child is having these serious side effects.
- you should know that your body fat may increase or move to different areas of your body such as your breasts and your upper back.

# What special dietary instructions should I follow
Unless your doctor tells you otherwise, continue your normal diet.

# What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Mild side effects
Stavudine may cause side effects. Tell your doctor if either of these symptoms is severe or does not go away:
- headache
- diarrhea

## Severe side effects
Some side effects can be serious. If you experience the following symptoms or any of those listed in the IMPORTANT WARNING section, call your doctor immediately:
- numbness, tingling, burning or pain in the hands or feet
- difficulty moving your hands and feet
- rash
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the capsules at room temperature and away from excess heat and moisture (not in the bathroom). Store the solution in the refrigerator and throw away the unused portion after 30 days. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- numbness, tingling, or pain in the hands or feet
- difficulty moving hands or feet
- upset stomach
- vomiting
- unusual or unexpected stomach pain
- weakness or tiredness
- shortness of breath
- weakness in arms and legs

# What other information should I know
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Zerit

# Other names
- d4T