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Stavudine is used to treat human immunodeficiency virus (HIV) infections. It is in a class of drugs known as antivirals.
Common brand names:Zerit
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Severe peripheral neuropathy (painful sensations due to nerve damage in the hands and feet) often develops in people taking stavudine or other drugs in its class. People with peripheral neuropathy who were taking one of these drugs were found to be deficient in acetyl-L-carnitine.1 In a preliminary trial, supplementing with 1,500 mg of acetyl-L-carnitine twice a day resulted in improvement in the neuropathy after six months in people taking stavudine or related drugs.2 Similar benefits were seen in another study that used the same amount of acetyl-L-carnitine.3
A 30-year-old woman who was taking stavudine developed a rare side effect called lactic acidosis, which was successfully treated with intravenous thiamine.4 Controlled studies are needed to determine whether lactic acidosis might be prevented if people taking stavudine supplement with vitamin B1. Until more information is available, some health practitioners may recommend supplemental vitamin B1 to individuals taking stavudine.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Potential Negative Interaction
1. Famularo G, Moretti S, Marcellini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 1997;11:185-90.
2. Hart AM, Wilson AD, Montovani C, et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS2004;18:1549-60.
3. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV Clin Trials 2005;6:344-50.
4. Schramm C, Wanitschke R, Galle PR. Thiamin for the treatment of nucleoside analogue-induced severe lactic acidosis. Eur J Anaesthesiol 1999;16:733-5.
Last Review: 03-18-2015
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