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Stavudine

Also indexed as: d4T, Stauvudine, Zerit

Illustration

Stavudine is used to treat human immunodeficiency virus (HIV) infections. It is in a class of drugs known as antivirals.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Acetyl-L-carnitine
Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Acetyl-L-carnitine

Vitamin B1*
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known
Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Vitamin B1 (thiamine)
A 30-year-old woman who was taking stavudine developed a rare side effect called lactic acidosis, which was successfully treated with intravenous thiamine.1 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.

Acetyl-L-carnitine
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.2 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.3 Similar benefits were seen in another study that used the same amount of acetyl-L-carnitine.4

References

1. Schramm C, Wanitschke R, Galle PR. Thiamin for the treatment of nucleoside analogue-induced severe lactic acidosis. Eur J Anaesthesiol 1999;16:733–5.

2. 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.

3. Hart AM, Wilson ADH, Montovani C, et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 2004;18:1549–60.

4. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV Clin Trials 2005;6:344–50.