GENERIC NAME: zalcitabine

BRAND NAME: Hivid

DRUG CLASS AND MECHANISM: Zalcitabine is an oral medication that is used for the treatment of infections with the human immunodeficiency virus (HIV). It is in a class of drugs called reverse transcriptase inhibitors which also includes lamivudine (Epivir), zidovudine (Retrovir), didanosine (Videx), and stavudine (Zerit). During infection with HIV, the HIV virus multiplies within the body's cells. The newly-formed viruses then are released from the cells and spread throughout the body where they infect other cells. In this manner, the infection continually spreads to new, uninfected cells that the body is continually producing, and HIV infection is perpetuated. When producing new viruses, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the enzyme that the virus uses to form this new DNA. Specifically, zalcitabine is converted within the body to its active form (dideoxycytidine triphosphate). This active form is similar to a compound (deoxycytidine triphosphate), a chemical that is required by the HIV virus to make new DNA. The reverse transcriptase uses dideoxycytidine triphosphate instead of deoxycytidine triphosphate for making DNA, and it is the dideoxycytidine triphosphate that interferes with the reverse transcriptase. Zalcitabine does not kill existing HIV virus and it is not a cure for HIV. Zalcitabine was approved by the FDA in June, 1992.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 0.375, 0.75 mg

STORAGE: Store tablets at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Zalcitabine is used for the treatment of HIV infection.

DOSING: The recommended dose for adults is 0.75 mg every 8 hours.

DRUG INTERACTIONS: Antacids containing aluminum or magnesium (e.g. Maalox) may reduce the absorption of zalcitabine leading to lower concentrations of zalcitabine in the body. This could reduce the effectiveness of zalcitabine.

Cimetidine (Tagamet) and probenecid (Benemid) increase the concentration of zalcitabine in the body. Increased levels of zalcitabine could result in more frequent or severe side effects.

PREGNANCY: Use of zalcitabine during pregnancy has not been adequately evaluated.

NURSING MOTHERS: It is not known whether zalcitabine is excreted in breast milk. HIV infected mothers should not breast feed because of the potential risk of transmitting HIV to an infant that is not infected.

SIDE EFFECTS: The most severe side effects are failure of the pancreas ( pancreatitis ), liver failure, metabolic disturbance (lactic acidosis) and peripheral neuropathy (damage to nerves). Symptoms of peripheral neuropathy are tingling, numbness and pain in the feet or hands. Other side effects are headache, fever, abdominal pain, nausea, vomiting, diarrhea, rash, mouth ulcers, painful swallowing and difficulty sleeping.

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