stavudine

CLINICAL USE

Nucleoside reverse transcriptase inhibitor:Treatment of HIV in combination with other antiretroviral drugs

DOSE IN NORMAL RENAL FUNCTION

<60 kg: 30 mg twice daily>60 kg: 40 mg twice daily

PHARMACOKINETICS

Molecular weight :224.2

%Protein binding :<1

%Excreted unchanged in urine : 40

Volume of distribution (L/kg) :0.5

half-life – normal/ESRD (hrs) :1–1.5/5.5–8

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

26–50 <60 kg: 15 mg twice daily >60 kg: 20 mg twice daily<25 <60 kg: 15 mg daily >60 kg: 20 mg daily

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR<25 mL/min

HD :Dialysed. Dose as in GFR<25 mL/min

HDF/high flux :Dialysed. Dose as in GFR<25 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR=26–50 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antivirals: zidovudine may inhibit intracellular activation – avoid concomitant use; increased risk of side effects with didanosine; effects possibly inhibited by ribavirinCytotoxics: effects possibly inhibited by doxorubicin; increased risk of toxicity with hydroxycarbamide – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

Administer at least an hour before food

OTHER INFORMATION

Clearance by haemodialysis is 120 mL/min Lactic acidosis, sometimes fatal, has been reported with the use of nucleoside analoguesPatients with ERF are more likely to develop peripheral neuropathy.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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