≥60kg: 40mg every 12hrs; <60kg: 30mg every 12 hrs. Withdraw drug if peripheral neuropathy occurs; after complete resolution, may restart at 20mg every 12 hrs for patients ≥60kg, or 15mg every 12 hrs for patients <60kg; if neuropathy recurs consider discontinuing permanently. Renal impairment: ≥60kg (CrCl 26–50mL/min): 20mg every 12 hrs; (CrCl 10–25mL/min): 20mg every 24 hrs. <60kg (CrCl 26–50mL/min): 15mg every 12 hrs; (CrCl 10–25mL/min): 15mg every 24 hrs. Hemodialysis: ≥60kg: 20mg every 24 hrs; <60kg: 15mg every 24 hrs. Coincide dose for end of dialysis and give at same time of day on non-dialysis days.
Children's Dose for ZERIT:
≤13 days: 0.5mg/kg every 12hrs. ≥14 days: (<30kg): 1mg/kg every 12 hours. ≥30kg: as adult. Withdraw drug if peripheral neuropathy occurs; after complete resolution, may restart at ½ recommended dose; if neuropathy recurs consider discontinuing permanently. Renal impairment: reduce dose or increase dosing interval.
Suspend therapy if symptoms of lactic acidosis or hepatotoxicity (eg, hepatomegaly, steatosis) occur. Suspend if pancreatitis suspected; may restart if ruled out, monitor closely (do not give with didanosine or hydroxyurea after restarted). Pre-existing liver dysfunction, hepatitis, or other risk factors of liver disease; monitor. Monitor for peripheral neuropathy. Advanced HIV disease, history of peripheral neuropathy, or concomitant neurotoxic drugs: consider reducing dose or discontinuing if neuropathy occurs; may attempt rechallenge at ½ dose. Women, obesity, or prolonged nucleoside exposure: increased risk of toxicity. Renal dysfunction. Diabetes (oral soln). Elderly. Pregnancy (Cat.C): monitor for lactic acidosis if used with didanosine. Nursing mothers: not recommended.
Avoid concomitant zidovudine. Increased risk of toxicity with neurotoxic, hepatotoxic, or pancreatotoxic drugs (eg, didanosine and/or hydroxyurea); avoid. Caution with doxorubicin, ribavirin. Monitor for treatment-associated toxicities with interferon-alpha with or without ribavirin.
Headache, GI upset, peripheral neuropathy, rash, elevated liver enzymes, elevated amylase, pancreatitis, lactic acidosis or severe hepatomegaly with steatosis, fat redistribution, immune reconstitution syndrome, anorexia, myalgia.
Register pregnant patients exposed to stavudine by calling (800) 258-4263.