Antiretroviral Agents: Nucleoside Reverse Transcriptase Inhibitors

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zalcitabine

Detailed Prescribing Information

October 2005

Hivid = zalcitabine = ddC
Forms Available	0.375 and 0.75 mg tablets
Dosing	Wt. < 60 kg: 0.375 mg po three times a day Wt. > 60 kg: 0.75 mg po three times a day
	Renal dosing¹	Ccr (cc/min)	Dose (mg)
		10-40	0.75 twice a day
		<10	0.75 daily
		hemodialysis	not recommended
	Hepatic dosing: unknown but zalcitabine does not undergo significant hepatic metabolism
Food dependence	This medication may be taken with or without food.
Adverse Effects	Well tolerated in most patients 25% incidence of peripheral neuropathy, oral ulcers, skin rash <1% incidence of pancreatitis. Rare lactic acidosis and hepatic steatosis
	Peripheral neuropathy - initially involves soles of feet, spreads cephlad, and may initially present as foreign body sensation. Monitor level of discomfort frequently and stop with any progression from "minimal" or “mild.” “Coasting effect” = peripheral neuropathy may continue to worsen for several weeks after discontinuation and then decrease in some cases.
Interactions	Increased neurotoxicity of other neuropathic drugs
Suggested lab follow-up	Serum lipase testing as indicated
Warning	Avoid use with d4T, ddI due to increased neurotoxicity.
Usage suggestions	Zalcitabine has been largely abandoned due to the high incidence of peripheral neuropathy and its relative low potency.
Complete prescribing information	http://www.rocheusa.com/products/hivid/pi.html

Links to Antiretroviral Sections (click on anything)

Nucleoside & Nucleotide Reverse Transcriptase Inhibitors (NRTI)

AZT | ddC | ddI | d4T | 3TC | ABC | FTC | TDF | Combivir | Trizivir | Epzicom | Truvada

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTI)

efavirenz | nevirapine | delavirdine

Protease Inhibitors (PI) | Boosted Protease Inhibitors

Fusion Inhibitors

enfuvirtide

Quick Menu / Table of Contents
Introduction	Principles	Management	NRTI Key	NRTI Info
NNRTI Key	NNRTI Info	PI Key	PI Info	Fusion Inhibitors
Drug Summary	Investigational	Adherence	Lab Evaluation	Resistance Tests
PEP	Antiretroviral Tables	OI Prevention	Vaccinations	TB Therapy
Hepatitis Therapy	OI Diagnosis	OI Therapy	Bibliography	Links

Updated 10.25.2005

1. Renal dosing information from: Ian R. McNicholl & Rudolph A. Rodriguez, MD, Dosing of Antiretroviral Drugs in Renal Insufficiency and Hemodialysis, May 2004
http://hivinsite.ucsf.edu/InSite?page=md-rr-18