Stavudine for HIV Zerit

Last updated by Peer reviewed by Sid Dajani
Last updated Meets Patient’s editorial guidelines

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Clinical author's note Michael Stewart 12/07/2022: Zerit® capsules were discontinued in the United Kingdom (UK) in January 2020. At the time of review there are no branded or generic products containing stavudine currently available in the UK. Stavudine (Zerit®) capsules may still be available in other countries. This Medicine Leaflet is based on medical information available in the UK at the time of writing and is left here for reference purposes only. Please refer to the information provided with your medicine.

Stavudine slows the progress of HIV infection. It is one of a number of medicines that you will need to take regularly.

For maximum effect, take your doses when your stomach is empty - so about an hour before a meal.

Stavudine has been associated with some serious side-effects. Your doctor will discuss these with you before you start treatment.

Type of medicineA nucleoside reverse transcriptase inhibitor antiretroviral medicine
Used forHuman immunodeficiency virus (HIV) infection, in adults and children
Also calledZerit® (discontinued in UK)
Available asCapsules (in US)

Stavudine is an antiretroviral medicine. It is prescribed for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Stavudine slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the virus from copying (replicating) itself.

Stavudine will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as nucleoside reverse transcriptase inhibitors (NRTIs). Stavudine will be prescribed for you if other, more usually prescribed NRTIs are not suitable for you. It is usually prescribed for a short time, after which your treatment will most likely be switched to an alternative antiretroviral. It is given alongside a number of other antiretroviral medicines as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine. It is vital to take your antiretroviral medicines exactly as prescribed to maintain success and to help to prevent the virus from becoming resistant to the medicines.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking stavudine it is important that your doctor knows:

  • If you are pregnant, trying for a baby or breastfeeding.
  • If you have any problems with the way your liver works, or if you have problems with the way your kidneys work.
  • If you drink a lot of alcohol.
  • If you have ever had inflammation of your pancreas, called pancreatitis.
  • If you have ever had peripheral neuropathy. This condition causes tingling or numbness, particularly in your hands or feet.
  • If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside your pack. It will give you more information about stavudine, and it will also provide you with a full list of the side-effects which you could experience from taking it.
  • Take stavudine exactly as your doctor tells you to. You will be asked to take two doses each day, 12 hours apart. Your doctor will tell you how much you should take for each dose. Your dose will also be printed on the label of the pack to remind you about what the doctor said to you.
  • Swallow the capsule with a drink of water. If you (or your child) have difficulties swallowing capsules, you can open the capsule and mix the contents with a little soft food.
  • Try to take stavudine at the same times each day, as this will help you to remember to take it regularly. Stavudine should preferably be taken while your stomach is empty, so about an hour before you eat a meal. If this is not possible, it can be taken after a light meal.
  • If you forget to take a dose at your usual time, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose and take the next dose as normal). Do not take two doses together to make up for a forgotten dose.
  • Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests to check how well your medicines are working.
  • It is important that you continue to take stavudine and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
  • If you develop an infection soon after you start the treatment, let your doctor know. As a result of taking stavudine, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
  • Follow carefully any advice your doctor gives to you about making lifestyle changes to reduce any risk of damage to your heart and blood vessels. These can include stopping smoking, eating healthily and taking regular exercise.
  • Some people taking antiretroviral medicines develop changes to the way body fat is distributed in the body. This can result in changes to body image. Your doctor will discuss the possibility of this with you.
  • Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
  • It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself then you should speak with your doctor straightaway.
  • Stavudine has been associated with a serious side-effect in some people who have taken it. This is known as lactic acidosis. It is a problem where there is too much lactic acid in the blood. The symptoms associated with it are listed in the next section 'Can stavudine cause problems?'. If you develop any of the symptoms listed below, you must let your doctor know straightaway, as they can worsen, and may even become life-threatening.
  • Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is a bone disease where bone tissue dies because there is a reduced blood supply to it. It leads to joint pains and stiffness, and can cause difficulties in movement. If you notice any of these symptoms, speak with your doctor.
  • If you buy any medicines, supplements or herbal remedies 'over the counter', check with a pharmacist that they are suitable to take with stavudine and your other medicines. This is because some medicines interfere with antiretrovirals and can stop them from working properly.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Treatment for HIV is usually lifelong. Continue to take stavudine regularly for as long as your doctor tells you to, even if you feel well. This is to keep your immune system healthy.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with stavudine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. You should, however, speak with your doctor if you develop any of the following side-effects. This is because some of the common side-effects of stavudine are similar to the symptoms of lactic acidosis - a less common but more serious problem.

Common stavudine side-effectsWhat can I do if I experience this?
Feeling sleepy, weak or dizzyDo not drive and do not use tools or machines while affected. If this continues, speak with your doctor
Tingling or numbness in areas of your arms, hands, legs or feetSpeak with your doctor about this as soon as possible
Feeling sick (nausea), diarrhoea, tummy (abdominal) pain, indigestionStick to simple meals - avoid rich or spicy food. If it continues, speak with your doctor
HeadacheDrink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know
Unusual dreams, sleeping problems, unusual thinking, feeling low or depressed, itchy rashIf any of these become troublesome, speak with your doctor

Your doctor will discuss with you the possibility of lactic acidosis occurring. Let your doctor know straightaway if you develop any of the following symptoms:

  • Feeling sick or being sick (vomiting), tummy pain, loss of appetite, loss of weight, feeling weak or dizzy, and fast or gasping breathing.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading and references