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Glossary

Approved for use in HIV infection in combination with other antiviral drugs.

DESCRIPTION: d4T is a nucleoside analogue or reverse transcriptase inhibitor.

DOSE: Adults / adolescents 40 mg twice a day (>60 kg), 30 mg twice a day (<60 kg); dose reduction for peripheral neuropathy 20 mg BID. Paediatric: 1 mg/kg every 12 hours (up to 30 kg) - available in powder form; Neonates: Under evaluation.

SIDE EFFECTS: Peripheral neuropathy is the most frequently reported toxicity of d4T. Enlarged fatty liver and lactic acidosis, including fatal cases have been reported. Mitochondrial toxicity.

RESISTANCE: There is considerable cross resistance among the NRTIs. People appear to develop a low resistance to d4T even after 2 years.

INTERACTIONS: ddI and ddC – overlapping toxicity with peripheral neuropathy maybe a problem. Using of ddI and d4T together is shown to be safe and effective. Drugs that cause peripheral neuropathy must be used with caution or avoided (INH, phenytoin, vincristine, hydralazine and long term metronidazole).

Nevirapine in combination with d4T can cause severe liver toxicity.

The combination of d4T and AZT is antagonistic and is not recommended.

Cytotoxic drug – doxorubicin may inhibit effect of d4T.

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