Stavudine is rapidly absorbed when taken orally. The absolute bioavailability of approximately 86.4%. After dianabol side effects for men a single dose of an oral dose maximum plasma concentration of the drug is observed in less than 1 hour. C max values increased in proportion to the dose of the drug. Cumulation stavudine when used every 6, 8 or 12 hours is observed. Use of the drug during or after a meal does not significantly affect the pharmacokinetics. The apparent volume of distribution after a single dose of the drug is an average of 66 liters and is independent of dose. The drug is distributed equally between the red and white blood cells. Binding to blood proteins significantly. After a single oral dose of 40 mg concentration cerebrospinal fluid was 63 ng / ml (mean 44 – 71 ng / ml) for 4-5 hours. The ratio to plasma concentration is about 40% (average 31-45%). After ingestion of the drug half-life is 1.44 hours and is independent of dose dianabol. Renal clearance was 40% of the total clearance, and almost twice the endogenous creatinine clearance, which indicates when an active tubular secretion stavudine excretion through the kidneys along with glomerular filtration.
Children. The absolute bioavailability of the drug in children is on average 76.9%. Pharmacokinetics after a single dose of the drug is similar to the pharmacokinetics of adults and does not depend on the dose. Drug concentrations in dianabol side effects for men after single and repeated oral administration comprise from 16 to 125% relative to concentration in plasma. Cumulation stavudine when receiving a dose of 0.125 -2 mg / kg every 12 hours is observed. The half-life is on average 1 hour. Approximately 34.5% of the drug is excreted through the kidneys in unchanged form. If impaired renal function, the clearance of stavudine decreases. Recommended dose adjustments (see. Dosage and administration). Patients with impaired liver function in stable condition initial dose adjustment is required.
Indications for use of treatment of HIV – infection (in combination with other nucleoside and non-nucleoside reverse transcriptase inhibitors and HIV protease inhibitors).
Contraindications: Hypersensitivity to stavudine and / or any of the excipients of the drug, children under the age of 3 months.
The caution alcoholism, chronic renal insufficiency (creatinine clearance less than 50 ml / min), liver failure, peripheral neuropathy, used in combination with didanosine, pancreatitis.
Pregnancy and lactation Use during pregnancy is possible only when the intended benefits to the mother outweighs the potential risk to the fetus. If necessary, use during lactation should stop breastfeeding.
Side effects when used in combination with other drugs with similar toxicity risk of side effects increases. Peripheral neuropathy is a severe and dose-dependent side effect of the drug. The risk of this effect increases with simultaneous use of didanosine. Peripheral neuropathy is usually accompanied by bilateral symmetrical limb numbness: tingling and pain in the soles of the feet and less in the hands. In clinical trials, the frequency of occurrence of these reactions depend on the dose and / or the stage of the disease. In the early stages of the disease, these phenomena are less frequent.
Pancreatitis varying dianabol side effects for men severity, including death, the patient can develop at different stages of treatment and does not depend on whether the drug is used alone or in combination with other drugs, or the degree of immunosuppression. In applying the drug in combination with didanosine, or other drugs that have toxic effects on the pancreas, increases the risk of developing pancreatitis. Lactic acidosis. Severe steatosis with hepatomegaly, including cases of death are marked nucleoside analogs when used in monotherapy or in combination with other antivirals, including stavudine. In the application of stavudine dbol side effects in combination with didanosine risk of liver dysfunction increases significantly. Nausea, vomiting, abdominal pain, rapid breathing or shortness of breath, or muscle weakness may indicate the development of lactic acidosis.
Other side effects include thrombocytopenia, hepatitis, abnormal liver function, fatigue, headache, insomnia, dizziness; dry mouth, decreased appetite, diarrhea, pancreatitis; increased activity of “liver” transaminases, hyperbilirubinemia, neutropenia, allergic reactions (skin rash, fever), arthralgia, myalgia, chills. Children: In clinical studies, side effects of the drug in pediatric and adult patients were similar. The development of peripheral neuropathy was observed less frequently in children than in adults. However, peripheral neuropathy symptoms in children was more difficult to identify.
Overdose peripheral neuropathy and hepatic dysfunction. . Treatment: symptomatic stavudine is removed by hemodialysis (clearance rate of 120 ± 18ml / min). The peritoneal dialysis is not effective.
Interaction with other drugs stavudine is not recommended for use in conjunction with zidovudine. Conversion of stavudine to its active metabolite is reduced in the presence of zidovudine, stavudine phosphorylation also slowed down in the presence of doxorubicin and ribavirin. Simultaneously taken didanosine, lamivudine and nelfinavir do not affect the effectiveness of the drug. The risk of side effects increases with simultaneous use of didanosine. Stavudine hardly binds to blood proteins, which indicates a low probability of drug-drug interactions involving the displacement mechanism of the binding sites. It is not recommended concomitant drugs that cause peripheral neurological disorders (chloramphenicol, cisplatin, dapsone , ethambutol, ethionamide, hydralazine, isoniazid, lithium, metronidazole, nitrofurantoin, phenytoin, vincristine, zalcitabine).
Special instructions: The drug should be used with caution in patients with increased risk of peripheral neuropathy, with advanced dianabol side effects for men infection, peripheral neuropathy with a history, and when used in combination with didanosine.The feeling of numbness, tingling, or pain in the limbs may indicate the development of peripheral neuropathy, which may disappear soon after stopping treatment. When these symptoms should temporarily discontinue the drug. Resuming drug treatment is possible only after the complete disappearance of symptoms. You may need to reduce the dose to half of the recommended. The drug should be used with caution in patients with an increased risk of pancreatitis, with advanced HIV infection, while the appointment with ddI. If symptoms of pancreatitis drug treatment should be suspended. With the reappointment of the drug to exclude the simultaneous use of didanosine and hydroxyurea. Regardless of how the drug dianabol review is used as monotherapy or in combination with other drugs, biochemical parameters of liver function may increase. With a view to the early detection of pancreatitis often necessary to check the function of the pancreas. how much to inject for weight loss
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