Zerit (stavudine) is a nucleoside reverse transcriptase inhibitor (NRTI) indicated for the treatment of human immunodeficiency virus (HIV-1) infection in combination with other antiretroviral agents. As a critical component of highly active antiretroviral therapy (HAART), Zerit works by inhibiting the reverse transcriptase enzyme, thereby impeding viral replication and reducing viral load. This medication is designed for use in both treatment-naïve and treatment-experienced patients, contributing to immunologic recovery and delaying disease progression. Proper adherence to prescribed regimens is essential to maximize therapeutic outcomes and minimize the risk of resistance development.

Features

• Active ingredient: Stavudine 15 mg, 20 mg, 30 mg, or 40 mg capsules
• Pharmacologic class: Nucleoside reverse transcriptase inhibitor (NRTI)
• Mechanism: Inhibits HIV reverse transcriptase by competing with natural substrate deoxythymidine triphosphate and incorporation into viral DNA
• Bioavailability: Approximately 86% following oral administration
• Half-life: 1.0-1.6 hours (intracellular half-life of active metabolite approximately 3.5 hours)
• Excretion: Primarily renal (approximately 40% unchanged drug)
• Storage: Room temperature (15-30°C) in tightly closed container

Benefits

• Effectively reduces HIV viral load when used in combination therapy
• Helps restore and preserve immune function by increasing CD4+ cell counts
• Delays progression to AIDS-defining illnesses and mortality
• Available in multiple strengths for individualized dosing
• Demonstrated efficacy in both adult and pediatric populations
• Established long-term safety profile with appropriate monitoring

Common use

Zerit is prescribed as part of combination antiretroviral therapy for the treatment of HIV-1 infection in adults and children. It is typically used in regimens containing at least three active drugs from different classes to ensure adequate viral suppression. The medication may be used in both initial therapy and salvage regimens, though current guidelines may prefer alternative NRTIs due to specific toxicity profiles. Clinical use requires consideration of the patient’s treatment history, resistance testing results, and comorbid conditions.

Dosage and direction

Adults weighing 60 kg or more: 40 mg twice daily
Adults weighing less than 60 kg: 30 mg twice daily
Pediatric patients: Dosage based on body weight (1 mg/kg twice daily for patients weighing less than 30 kg; for patients 30 kg or more, use adult dosing)

Administration guidelines:

• Take with or without food
• Maintain consistent dosing schedule approximately every 12 hours
• Do not crush or chew capsules; swallow whole with water
• Dosage adjustment required in renal impairment
• Complete the full prescribed course unless directed otherwise by healthcare provider

Precautions

• Monitor for signs of peripheral neuropathy, which may require dosage modification or discontinuation
• Regular assessment of liver function tests recommended
• Monitor for lactic acidosis and hepatic steatosis, especially in women and obese patients
• Pancreatitis has been reported; monitor amylase levels if symptoms develop
• Lipoatrophy (loss of subcutaneous fat) may occur and may be irreversible
• Regular monitoring of complete blood count, CD4 count, and viral load essential
• Use with caution in patients with pre-existing liver disease or risk factors for liver disease
• May cause redistribution/accumulation of body fat

Contraindications

• Hypersensitivity to stavudine or any component of the formulation
• Concomitant use with zidovudine (may antagonize effects)
• Patients with established pancreatitis or history of pancreatitis
• Severe hepatic impairment without appropriate dosage adjustment
• Pregnancy unless potential benefit justifies potential risk to fetus
• Breastfeeding is not recommended due to potential for HIV transmission and adverse effects

Possible side effect

Common (≥1%): Peripheral neuropathy, headache, nausea, diarrhea, rash, insomnia
Less common (0.1-1%): Pancreatitis, lactic acidosis, hepatic steatosis, lipodystrophy, elevated liver enzymes
Rare (<0.1%): Severe hypersensitivity reactions, hepatic failure, myopathy, optic neuritis
Laboratory abnormalities: Increased amylase, increased liver transaminases, hyperglycemia, elevated triglycerides

Drug interaction

• Zidovudine: Antagonistic effect; concomitant use contraindicated
• Doxorubicin: Potential increased risk of toxicity
• Ribavirin: May antagonize antiretroviral activity
• Other medications causing peripheral neuropathy: May increase risk (isoniazid, metronidazole, etc.)
• Nephrotoxic drugs: May affect clearance (aminoglycosides, amphotericin B)
• Methadone: May decrease stavudine levels; monitoring recommended

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Maintain regular dosing schedule to ensure consistent drug levels. If multiple doses are missed, contact healthcare provider for guidance on resuming therapy.

Overdose

Limited experience with overdose. Symptoms may include peripheral neuropathy, hepatic toxicity, pancreatitis, and lactic acidosis. There is no specific antidote. Treatment should be supportive and symptomatic, including monitoring of vital signs and laboratory parameters. Hemodialysis may remove approximately 40% of the administered dose. Contact poison control center for latest guidance.

Storage

Store at room temperature between 15-30°C (59-86°F). Keep container tightly closed and protect from moisture. Do not freeze. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Properly dispose of unused medication according to local regulations.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Zerit should be used only under the supervision of a qualified healthcare provider familiar with HIV management. Treatment decisions should be based on individual patient characteristics, resistance testing, and current treatment guidelines. The prescribing physician should be consulted for specific recommendations and monitoring requirements.

Reviews

“Zerit has been a cornerstone in our HIV treatment arsenal for years. While we now have newer agents with improved toxicity profiles, stavudine remains an important option in resource-limited settings where alternatives may not be available. The key is appropriate patient selection and vigilant monitoring for toxicities.” - Infectious Disease Specialist, 15 years experience

“In our clinical trials, Zerit-containing regimens demonstrated significant viral suppression and CD4 recovery. The development of lipoatrophy has led to decreased use in developed countries, but it remains a viable option when carefully monitored.” - Clinical Researcher, HIV Therapeutics

“Patient education is crucial with Zerit therapy. Those who understand the monitoring requirements and early signs of toxicity generally do well. The twice-daily dosing is manageable for most patients when combined with appropriate support.” - HIV Specialist Nurse, 10 years experience