Lamivudine-Stavudine PrecautionsStavudine therapy has rarely been associated with motor weakness, occuring predominantly in the setting of lactic acidosis. If motor weakness develops or the patient is suspected with lactic acidosis, immediately suspend therapy with stavudine. Permanent discontinuation should be considered for patients with confirmed lactic acidosis.
Stavudine therapy has also been associated with peripheral sensory neuropathy, which can be severe, is dose related, and occurs more frequently in patients being treated with neurotoxic drug therapy, including didanosine, in patients with advanced HIV infection, or in patients who have previously experienced peripheral neuropathy.
Patients should be monitored for the development of neuropathy. Stavudine related neuropathy may resolve is therapy is withdrawn promptly, in some cases symptoms may worsen temporarily following the discontinuation of therapy. If symptoms resolve completely, patients may tolerate resumption of treatment at one half of the dose, If neuropathy recurs thereafter, discontinuation of stavudine should be considered.
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