d4T

  

New Mexico AIDS InfoNet Fact Sheet Number 423

d4T (Zerit)

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• WHAT IS d4T?
• WHO SHOULD TAKE d4T?
• WHAT ABOUT DRUG RESISTANCE? 
• HOW IS d4T TAKEN?
• WHAT ARE THE SIDE EFFECTS?
• HOW DOES d4T REACT WITH OTHER DRUGS?

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WHAT IS d4T?

d4T (Zerit®), is a drug used for antiviral

therapy. It is manufactured by Bristol-Myers Squibb. d4T is

also known as stavudine or didehydro-deoxythymidine.

d4T is a nucleoside analog reverse transcriptase inhibitor,

or nuke. These drugs block the reverse transcriptase enzyme. This

enzyme changes HIV’s genetic material (RNA) into the form of DNA.

This has to occur before HIV’s genetic code gets inserted into

an infected cell’s own genetic codes.

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WHO SHOULD TAKE

d4T?

d4T was approved as an antiviral drug for people with HIV infection.

There are no absolute rules about when to start antiviral drugs.

You and your doctor should consider your T-cell

count, your viral load,

any symptoms you are having, and your attitude about taking HIV

medications. Fact Sheet 411

has more information about guidelines

for the use of antiviral medications.

If you take d4T with other antiviral drugs, you can reduce

your viral load to extremely low levels, and increase your T-cell

counts. This should mean staying healthier longer.

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WHAT ABOUT DRUG

RESISTANCE? 

Many new copies of HIV are mutations. They are slightly different

from the original virus. Some mutations can keep multiplying even

when you are taking an antiviral drug. When this happens, the

drug will stop working. This is called “developing resistance”

to the drug. See Fact Sheet 414

for more information on resistance.

Sometimes, if your virus develops resistance to one drug, it

will also have resistance to other antiviral drugs. This is called

“cross-resistance”.

Resistance can develop quickly. It is very important to

take antiviral medications according to instructions, on schedule,

and not to skip or reduce doses.

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HOW IS d4T TAKEN?

d4T is available in capsules of 15mg, 20mg, 30mg, and 40mg.

The normal adult dose depends on body weight. If you weigh more

than 60 kilograms (132 pounds), the dose is 40 mg twice daily.

If you weigh less, the dose is 30 mg twice daily.

Be sure your doctor knows if you have had liver problems. Your

liver will have to be watched carefully if you take d4T, and your

doctor might decide that you should not use d4T at all.

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WHAT ARE THE

SIDE EFFECTS?

When you start any anti?viral treatment, you may have temporary

side effects such as headaches, hypertension, or a general sense

of feeling ill. These side effects usually get better or disappear

over time.

The most serious side effects of d4T are peripheral

neuropathy, lipodystrophy

and lactic acidosis.

Peripheral neuropathy is a form of nerve damage. It

usually shows up as tingling, numbness, or a sharp burning sensation

in the feet, legs, or hands. The nerve damage is usually temporary

and will go away if you stop taking d4T, or reduce the dose. If

you continue to take d4T after nerve damage shows up, it may become

permanent. See Fact Sheet 555

for more information.

Lipodystrophy is a collection of changes in body shape

and blood chemistry. See Fact

Sheet 553 for more information. Several studies found that

d4T is strongly linked to the loss of fat in the legs, arms and

face. Many drugs seem to contribute to lipodystrophy and we don’t

fully understand how it occurs. However, some people are avoiding

d4T because of its link to lipodystrophy.

Lactic acidosis is a buildup of lactic acid in the blood.

This is a by-product of abnormal energy production by the cells.

It may be caused by damage to the mitochondria. See Fact

Sheet 556 for more information on mitochondrial

toxicity. Lactic acidosis can cause severe damage to the pancreas

and liver. Symptoms of lactic acidosis can include weight loss,

abdominal pain, and severe fatigue.

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HOW

DOES d4T REACT WITH OTHER DRUGS?

d4T should not be taken with AZT (zidovudine, Retrovir®)

or ddC (zalcitabine, Hivid®).

d4T’s side effects may be worse if taken with ganciclovir

or pentamidine.

Pregnant women should not take d4T and ddI at the same

time due to an increased risk of lactic acidosis.

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Revised November

11, 2002

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