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zalcitabine; dideoxycytosine; ddC (Hivid)
Tradename: Hivid.
Indications:
- management of patients with HIV in combination with other retroviral agents
Contraindications: Caution:
- may exacerbate liver dysfunction in patient with liver disease or history of alcohol abuse
Dosage: 0.75 mg PO every 8 hours.
Tabs: 0.375 & 0.75 mg.
Dosage adjustment in renal failure:
creatinine clearance dosage
10-40 mL/min 0.75 mg every 12 hours
< 10 mL/min* 0.75 mg every 24 hours
* dose after hemodialysis
Pharmacokinetics:
-> elimination 1/2life 2.0 hours (> 8 hours ESRD)
Adverse effects:
1) common (> 10%)
- oral ulcers
2) less common (1-10%)
- nausea/vomiting, dysphagia, anorexia, abdominal pain, diarrhea, rash, pruritus, headache, dizziness, myalgia, foot pain, fatigue, pharyngitis, chest pain, weight loss
3) uncommon (< 1%)
- constipation, night sweats, fever, pain, malaise, asthenia, edema, hypertension, palpitations, syncope, atrial fibrillation, tachycardia, epistaxis, hyperglycemia, hypocalcemia, jaundice, hepatitis, myositis
4) other
- peripheral neuropathy
- dose-dependent
- painful
- predominantly distal, symmetric sensory polyneuropathy
- rash
- fatal pancreatitis (rare)
Drug interactions:
1) DO NOT USE in combination with
a) stavudine (d4T)
b) didanosine (ddI)
c) lamivudine (3TC)
2) antacids may reduce levels of ddC
Mechanism of action:
- a cytidine analog
- transported by SLC28A1
Interactions
drug interactions
drug adverse effects of antiretroviral agents
General
nucleoside reverse transcriptase inhibitor (NRTI)
Properties
MISC-INFO: elimination route KIDNEY
1/2life 2.0 HOURS
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Department of Veterans Affairs, VA National Formulary