Madison Clinic
For Providers For Patients Pharmacy Calendar Resources

[Print PDF 38kb]


Other Names: d4T, Zerit®
Manufacturer: Bristol-Meyers Squibb

What is it?

Stavudine is an antiretroviral drug, specifically a nucleoside reverse transcriptase inhibitor. It is used to treat HIV, a retrovirus. Retroviruses use the genetic material in the body’s cells to produce more virus which can infect other cells.

How does it work?

Stavudine interferes with the life cycle of HIV to stop it from producing more virus. Specifically, it ties up the reverse transcriptase enzyme so it cannot build the genetic material needed to make more virus and infect more cells. This medication is used in combination with other antiretroviral drugs to inhibit HIV reproduction.

How do I take it?

  • Stavudine is available in 15mg, 20mg, 30mg and 40mg capsules.
  • The usual dose is 1 capsule twice daily (dose may be reduced for weight under 132 lbs., for decreased kidney function, or to alleviate side effects such as peripheral neuropathy)
  • Your dose will be ___________________________________.
  • Stavudine may be taken with or without food.

It is extremely important that you take stavudine and your other antiretroviral medications exactly as directed. You should set up a system that will help you remember to take your medicines so that you do not miss any doses. If you miss a dose, take it as soon as possible and space the remaining doses out over the rest of the day. However, if you skip a dose, do not take two doses at once. Do not stop taking the medication for any reason at any time unless you are directed to do so by your provider. If you are unable to continue taking your medication due to side effects, you should contact your provider immediately.

Special Considerations

  • d4T should be stored at controlled room temperature in a dry place, out of the reach of children.
  • Please bring your medication bottles (empty and partially used) to each study visit.


Some drugs taken together may have interactions that cause illness or impair the effectiveness of the drugs. It is a good idea to always check with your study clinician before taking any other medications, prescription or otherwise, to be sure it will not interact with d4T.

It is possible that taking d4T with other medicines that have a potential to cause peripheral neuropathy (tingling or numbing sensation in hands and/or feet) may increase your risk of developing neuropathy.

Side Effects

Not everyone experiences side effects. When they do occur, they may be mild, moderate or severe. Some side effects cannot be felt by the patient but can be found through laboratory tests, so it is important to see your provider regularly for checkups so that side effects can be detected early and treated.

The most common side effects of stavudine are peripheral neuropathy (tingling or numbing sensations in the hands and/or feet), pancreatitis (inflammation of the pancreas which may cause nausea, vomiting, stomach pain), changes in liver function, and neutropenia (low white blood cell count). Other side effects seen with stavudine include fever, headache, and anemia (low red cell count)

Symptoms of anemia or neutropenia that you may notice include unusual tiredness or weakness, shortness of breath, or any sign of infection. If you begin having these symptoms, please contact your provider.

Excessive consumption of alcohol may increase the risk of developing pancreatitis.

Nucleoside reverse transcriptase inhibitors such as stavudine have been associated with a condition called lactic acidosis. Lactic acidosis is a build-up of lactic acid, a byproduct of muscle metabolism, in the blood. Early symptoms can be vague and non-specific and can include nausea, vomiting, fatigue, abdominal pain, sudden unexplained weight loss, and shortness of breath. If you are experiencing these symptoms and they cannot be explained by other causes, please contact your provider immediately. Although lactic acidosis is a rare condition, it can be life-threatening if not treated.

[top of page]