Drug interactions

The combination of d4T (stavudine, Zerit) with AZT (zidovudine, Retrovir) is antagonistic, with each drug reducing the two drugs’ combined anti-HIV effects.1 Consequently, this combination is not recommended.

Taking the hepatitis C treatment ribavirin (Copegus / Rebetol / Virazole) when also taking d4T may increase the risk of a set of side-effects associated with elevated lactate including the rare, life-threatening condition lactic acidosis.2 It may also increase the risk of body fat loss.3 Test-tube studies also suggest that ribavirin and doxorubicin (Caelyx / Myocet) may block the production of the active form of d4T in the body, reducing the drug’s anti-HIV effects.

Caution should be used when d4T is taken with other drugs that may cause peripheral neuropathy. These include:

  • Chloramphenicol (Kemicetine).
  • Cisplatin (Platinex)
  • Dapsone.
  • ddC (zalcitabine, Hivid).
  • ddI (didanosine, Videx / VidexEC).
  • Ethambutol.
  • Ethionamide.
  • Hydralazine (Aprelosine).
  • Isoniazid.
  • Lithium (Camcolit / Liskonum / Priadel).
  • Metronidazole (Flagyl / Flagyl S / Metrolyl).
  • Nitrofurantoin (Furadantin / Macrobid / Macrodantin).
  • Phenytoin (Epanutin).
  • Vincristine (Oncovin).

References

  1. Havlir DV et al. In vivo antagonism with zidovudine plus stavudine combination therapy. J Infect Dis 182: 321-325, 2000
  2. Garcia-Benayas T et al. Weight loss in HIV-infected patients. N Engl J Med 346: 1287-1288, 2002
  3. Hor T et al. Concomitant ddI / d4T and IFN (standard or pegylated) / ribavirin treatments may induce a high risk of mitochondrial toxicity in HIV / HCV infected patients (ANRS HCO-2 RIBAVIC study). 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, abstract H-1735, 2002
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.