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AIDSinfo Drug Database

AIDSinfo Drug Database

Drugs by class



Stavudine  Audio icon

Brand Name: Zerit
Other Names: d4T
Drug Class: Nucleoside Reverse Transcriptase Inhibitors
Approved Use: Treatment of HIV Infection

Drug Image:
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Stravudine 15
Stavudine 20
Stavudine 30
Stavudine 40
Chemical Image:
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Molecular Weight: 224.2148


Stavudine can cause serious, life-threatening side effects. These include lactic acidosis (buildup of lactic acid in the blood), liver problems, and pancreatitis (inflammation of the pancreas).

The risk of lactic acidosis may be higher if you have liver problems, are female, are pregnant, are overweight, or have been treated for a long time with other HIV medicines. There have been deaths reported in pregnant women who developed lactic acidosis after taking stavudine and didanosine (another HIV medicine).

Contact your health care provider right away if you have any of the following symptoms that could be signs of lactic acidosis:

  • Unexplained weight loss.
  • Weakness or tiredness.
  • Unusual muscle pain.
  • Trouble breathing.
  • Stomach pain with nausea and vomiting.
  • Feeling cold, especially in your arms and legs.
  • Dizziness or lightheadedness.
  • Fast or irregular heartbeat.

Contact your health care provider right away if you have any of the following symptoms that could be signs of liver problems:

  • Yellowing of your skin or the whites of your eyes (jaundice).
  • Dark-colored urine.
  • Pain on the right side of your stomach.
  • Swelling of your stomach.
  • Easy bruising or bleeding.
  • Loss of appetite.
  • Nausea.
  • Vomiting. 

Contact your health care provider right away if you have any of the following symptoms that could be signs of pancreatitis:

  • Stomach pain.
  • Swelling of your stomach.
  • Nausea.
  • Vomiting.
  • Fever.

While taking stavudine, it is important to keep all of your appointments with your health care provider.

What is stavudine?

Stavudine is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of HIV infection in adults, children, and infants. Stavudine is always used in combination with other HIV medicines.

Stavudine belongs to a class (group) of HIV drugs called nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs block an HIV enzyme called reverse transcriptase. (An enzyme is a protein that starts or increases the speed of a chemical reaction.) By blocking reverse transcriptase, NRTIs prevent HIV from multiplying and can reduce the amount of HIV in the body.

HIV medicines can’t cure HIV/AIDS, but taking a combination of HIV medicines (called an HIV regimen) every day helps people with HIV live longer, healthier lives. HIV medicines also reduce the risk of HIV transmission. If you are taking HIV medicines, including stavudine, don’t cut down on, skip, or stop taking them unless your health care provider tells you to.

What should I tell my health care provider before taking stavudine?

Before taking stavudine, tell your health care provider:

  • If you are allergic to stavudine or any other medicines.
  • If you have or had liver problems (such as hepatitis).
  • If you have or had kidney problems.
  • If you have or had problems with your pancreas (such as pancreatitis).
  • If you have gallstones.
  • If you have or had persistent numbness, tingling, or pain in the hands or feet (peripheral neuropathy).
  • If you have any other medical conditions.
  • If you drink alcoholic beverages.
  • If you are pregnant or plan to become pregnant. Whether stavudine can harm an unborn baby is unknown. The combination of stavudine and didanosine (another HIV medicine) should be used with caution during pregnancy and only if the potential benefit clearly outweighs the potential risk to the fetus. Tell your healthcare provider right away if you become pregnant while taking stavudine. You and your healthcare provider will decide if you should take stavudine while you are pregnant.
  • If you are breastfeeding or plan to breastfeed. Do not breastfeed if you are infected with HIV or are taking stavudine.
  • About other prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Stavudine may affect the way other medicines or products work, and other medicines or products may affect how stavudine works. Taking stavudine together with certain medicines or products may cause serious, life-threatening side effects.

How should I take stavudine?

Stavudine (brand name: Zerit) comes in capsule form in the following strengths:

  • 15-mg capsules.
  • 20-mg capsules.
  • 30-mg capsules.
  • 40-mg capsules.

Stavudine also comes as a 1-mg/mL oral solution (brand name: Zerit). A pharmacist prepares the stavudine oral solution by mixing stavudine powder with purified water.

Take stavudine according to your health care provider’s instructions.

Take stavudine with or without food. Avoid drinking alcohol while taking stavudine. Alcohol may increase your risk of getting pain and swelling of your pancreas (pancreatitis) or may damage your liver.

When giving stavudine oral solution to a child, shake the bottle well before measuring each dose.

Always take stavudine in combination with other HIV medicines.

If you take too much stavudine, contact your health care provider or local poison control center (1-800-222-1222) right away, or go to the nearest hospital emergency room.

For more information on how to take stavudine, see the FDA drug label from DailyMed. (DailyMed is a federal website that includes the most recent drug labels submitted to FDA.)

What should I do if I forget a dose?

If you miss a dose of stavudine, take the missed dose as soon as you remember it. But if it is almost time for your next dose, skip the missed dose and just take your next dose at the regular time. Do not take two doses at the same time to make up for a missed dose.

What side effects can stavudine cause?

Stavudine may cause side effects. Most side effects from stavudine are manageable, but a few can be serious. Serious side effects of stavudine include lactic acidosis (buildup of lactic acid in the blood), liver problems, and pancreatitis (inflammation of the pancreas). (See the WARNING above.)

Other possible side effects of stavudine include:

  • Neurologic symptoms (signs that stavudine may be affecting the nerves). Tell your health care provider right away if you have any numbness in your hands or feet, tingling in your hands or feet, or weakness in your legs, feet, arms, or hands. Neurologic symptoms can be difficult to notice in children who take stavudine. Ask your child’s healthcare provider for the signs and symptoms of this side effect in children.
  • Changes in body fat (including gain or loss of fat).
  • Immune reconstitution inflammatory syndrome (IRIS), a condition that sometimes occurs when the immune system begins to recover after treatment with an HIV medicine. As the immune system gets stronger, it may have an increased response to a previously hidden infection.

Tell your health care provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of stavudine. To learn more about possible side effects of stavudine, read the drug label or package insert or talk to your health care provider or pharmacist.

The AIDSinfo fact sheet on HIV Medicines and Side Effects also includes information that may apply to stavudine.

You can also report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088) or online at

How should stavudine be stored?

Stavudine capsules:

  • Store stavudine capsules at 59°F to 86°F (15°C to 30°C).
  • Keep the capsule container tightly closed. 

Stavudine oral solution:

  • Keep stavudine oral solution in the bottle that it came in. Do not use the oral solution if the seal over the bottle opening is broken or missing.
  • Store the bottle of stavudine oral solution in the refrigerator at 36°F to 46°F (2°C to 8°C). Keep the bottle tightly closed.
  • Throw away any unused stavudine oral solution after 30 days.
  • Throw away stavudine that is no longer needed or expired (out of date). Follow FDA guidelines on how to safely dispose of unused medicine.
  • Keep stavudine and all medicines out of reach of children.

Where can I find more information about stavudine?

More information about stavudine is available:

Manufacturer Information

Bristol-Myers Squibb

The above Patient Version drug summary is based on the following FDA label(s): Capsule (gelatin coated), powder (for solution).

Last Reviewed: December 17, 2015

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