Zerit (stavudine) is a nucleoside reverse transcriptase inhibitor (NRTI) indicated for the treatment of human immunodeficiency virus (HIV-1) infection in combination with other antiretroviral agents. As a critical component of highly active antiretroviral therapy (HAART), Zerit works by inhibiting the reverse transcriptase enzyme, thereby impeding viral replication and reducing viral load. This medication is formulated to support immune reconstitution, delay disease progression, and improve clinical outcomes in appropriately selected patients. Zerit is available in capsule and oral solution forms, offering flexibility in dosing for both adult and pediatric populations under strict medical supervision.

Features

• Contains stavudine as the active pharmaceutical ingredient
• Available in 15 mg, 20 mg, 30 mg, and 40 mg capsules
• Oral solution formulation (1 mg/mL) for pediatric and dosing flexibility
• Manufactured under current Good Manufacturing Practices (cGMP)
• Requires prescription and regular clinical monitoring

Benefits

• Effectively reduces HIV viral load when used in combination therapy
• Helps restore and preserve CD4+ T-cell counts
• Delays progression to AIDS-defining illnesses
• Supports long-term viral suppression with adherence to regimen
• Available in multiple formulations to accommodate patient needs
• Contributes to improved quality of life and survival rates

Common use

Zerit is primarily used as part of combination antiretroviral therapy for the treatment of HIV-1 infection in both treatment-naïve and treatment-experienced patients. It is typically prescribed alongside other antiretroviral agents from different classes to create a potent regimen that prevents viral replication through multiple mechanisms. The medication is used in adult and pediatric patients weighing at least 30 kg, with careful consideration of the benefit-risk profile, particularly regarding potential metabolic complications. Zerit may be included in various HAART regimens tailored to individual patient characteristics, resistance patterns, and comorbidities.

Dosage and direction

Adults (weighing 60 kg or more): 40 mg twice daily
Adults (weighing less than 60 kg): 30 mg twice daily
Pediatric patients: Dosage based on body weight - consult prescribing information for specific weight-based dosing guidelines

Zerit may be taken with or without food. The capsules should be swallowed whole with water. The oral solution should be measured using the provided dosing syringe or device. Dosing intervals should be approximately 12 hours apart to maintain consistent drug levels. Dosage adjustments are required in patients with renal impairment - consult full prescribing information for specific creatinine clearance-based dosing recommendations. Treatment should be initiated and monitored by healthcare providers experienced in the management of HIV infection.

Precautions

Peripheral neuropathy, which may be severe and potentially irreversible, has been associated with Zerit use. Patients should be frequently monitored for symptoms including numbness, tingling, or pain in hands or feet. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with nucleoside analogue use. Pancreatitis has occurred during therapy with Zerit, and patients with a history of pancreatitis or risk factors for pancreatitis should be monitored closely. Lipoatrophy and metabolic disorders including hyperlipidemia and insulin resistance have been associated with stavudine therapy. Regular monitoring of liver function, amylase, lipase, and metabolic parameters is recommended throughout treatment.

Contraindications

Zerit is contraindicated in patients with known hypersensitivity to stavudine or any component of the formulation. Concomitant use with didanosine is not recommended due to increased risk of toxicities including pancreatitis, peripheral neuropathy, and lactic acidosis. The medication is contraindicated in patients with pre-existing hepatic failure or severe renal impairment without appropriate dosage adjustment. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus, following thorough risk-benefit assessment.

Possible side effects

Common (≥1%): Peripheral neuropathy, headache, nausea, diarrhea, rash, insomnia
Less common: Pancreatitis, hepatic steatosis, lactic acidosis, lipodystrophy, hyperglycemia
Rare but serious: Severe hepatotoxicity, Stevens-Johnson syndrome, autoimmune disorders
Laboratory abnormalities: Elevated liver enzymes, increased amylase/lipase, hypertriglyceridemia, neutropenia

Patients should be advised that peripheral neuropathy may occur and to report symptoms promptly. Regular monitoring can help detect metabolic abnormalities early. Most side effects are manageable with dose modification or discontinuation, though some (like lipoatrophy) may be irreversible.

Drug interaction

Zerit demonstrates interactions with several medications that require careful management. Concomitant use with other neurotoxic drugs (including vincristine, isoniazid, and metronidazole) may increase the risk of peripheral neuropathy. Combination with didanosine is not recommended due to overlapping toxicities. Drugs that inhibit or induce cytochrome P450 enzymes have minimal effect on stavudine pharmacokinetics. However, medications that compete for renal excretion may affect stavudine clearance. Zidovudine may antagonize the antiviral effects of stavudine and concurrent use is not recommended. Healthcare providers should review all concomitant medications, including over-the-counter products and herbal supplements.

Missed dose

If a dose is missed, patients should take it as soon as they remember, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed dose. Consistent adherence to the prescribed regimen is critical for maintaining viral suppression and preventing the development of resistance. Healthcare providers should educate patients on the importance of adherence and strategies to avoid missed doses.

Overdose

There is limited experience with Zerit overdose. Experience from clinical trials suggests that higher doses are associated with an increased incidence of peripheral neuropathy and hepatic toxicity. There is no specific antidote for stavudine overdose. Treatment should consist of general supportive measures, including monitoring of vital signs and observation of clinical status. Hemodialysis removes stavudine and may be considered in overdose situations, particularly in patients with renal impairment. Healthcare providers should contact a poison control center for current information on the management of overdose.

Storage

Store Zerit capsules at controlled room temperature 20°-25°C (68°-77°F) with excursions permitted between 15°-30°C (59°-86°F). Keep in the original container with the lid tightly closed to protect from moisture. The oral solution should be stored in the refrigerator between 2°-8°C (36°-46°F) but may be kept at room temperature for up to 30 days. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Proper disposal of unused medication should follow local regulations or medication take-back programs.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Zerit should only be used under the supervision of a qualified healthcare provider experienced in the management of HIV infection. Treatment decisions should be based on the individual patient’s condition, treatment history, and current treatment guidelines. Patients should not adjust their dosage or discontinue treatment without consulting their healthcare provider. The full prescribing information contains additional important safety information and should be reviewed before initiating therapy.

Reviews

“After incorporating Zerit into my treatment regimen, my viral load became undetectable within three months. The side effects were manageable with proper monitoring, and the twice-daily dosing fits well with my schedule.” - M.K., treated for 2 years

“As a healthcare provider, I’ve found Zerit to be effective in combination therapy, though I carefully monitor patients for metabolic changes and neuropathic symptoms. The weight-based dosing allows for appropriate individualization.” - Infectious Disease Specialist

“While effective virologically, I developed lipoatrophy after several years on Zerit. My provider switched me to an alternative regimen, but the physical changes have been permanent. Careful benefit-risk assessment is essential.” - R.T., former patient

“The oral solution formulation has been invaluable for my pediatric patients. It allows precise dosing adjustments as children grow, though we maintain vigilant monitoring for potential toxicities.” - Pediatric HIV Specialist