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Potential side effects and toxicity:
Peripheral neuropathy (tingling, burning, numbness or pain in the hands or feet) may go away once Hivid is stopped, but can be painful and permanently debilitating if not treated in time. Other side effects include headache, fever, skin eruptions, sores or swelling in the mouth, nausea, and pancreatitis. Rare but potentially fatal toxicity with all NRTIs is pancreatitis (inflammation of the pancreas), hepatomegaly (enlarged liver) with steatosis and lactic acidosis (accumulation of lactate in the blood and abnormal acid-base balance). Lactic acidosis has been seen in patients taking NRTIs but is more common and more severe in women, people who are obese and people who have been taking nukes for a long time; and more common in people with liver disease, but can occur in people without a history of liver damage. People with lactic acidosis may experience persistent fatigue, abdominal pain or distension, nausea/vomiting, and difficulty breathing or shortness of breath; and enlarged, fatty liver (called hepatomegaly with steatosis).
People with a history of peripheral neuropathy, pancreatitis or heavy alcohol use should avoid Hivid. Pancreatitis can be life-threatening and may cause pain in the stomach and back, along with nausea, vomiting and blood in the urine. Your physician will check for pancreatitis by checking for increased levels of amylase and lipase in the blood. Risks for pancreatitis include: higher than recommended doses of NRTIs, advanced HIV, and alcohol use. Body fat redistribution/accumulation has also been reported with Hivid. With few exceptions, these side effects are stronger than is seen with other NRTIs.
Potential drug interactions: Due to increased risks associated with peripheral neuropathy, Hivid should not be taken with Videx (ddI) or Zerit (d4T). Epivir (3TC) and Emtriva (FTC) should also be avoided as they can lower the levels of Hivid in the body. Other medications that can interact with Hivid include Antabuse (disulfiram), Fungizone (amphotericin B), Benemid (probenecid), Chloromycetin (chloramphenicol), certain chemotherapy agents, Dilantin (phenytoin), dapsone, Foscavir (foscarnet), isoniazid, Flagyl (metronidazole), hydralazine, ribavirin, and Macrodantin/Macrobid (nitrofurantoin). When used at the same time as Tagamet (cimetidine) and Benemid (probenecid) monitor for renal toxicity. Maalox and Foscavir may decrease Hivid levels. When used with Hivid, pentamidine (NebuPent, Pentam or Pentacarinat, used for treating Pneumocystis jiroveci pneumonia (PCP), may increase risk of pancreatitis. Hivid should not be taken at the same time with antacids containing magnesium or aluminum, as they may decrease levels of Hivid in the body.
Tips: Is expected to be taken off the market in 2006, due to rare use, lack of potency and side effects. For a long time rarely used, Hivid is being prescribed more in salvage therapy. Hivid should be avoided if you are pregnant or breast feeding. Notify your doctor immediately if peripheral neuropathy is suspected, but do not stop medication unless directed to do so by your healthcare provider.
Doctor
Zalcitabine (ddC) is almost never used anymore for a myriad of reasons. It is recognized as the weakest of the nucleoside analogs. It requires an inconvenient dosing of three times a day. It is most commonly associated with side effects such as pancreatitis and peripheral neuropathy and therefore should not be used with ddI or d4T.—Chad J. Zawitz, MD
Activist
No need to talk about it since it is no longer available due to toxicity.—Nelson Verge
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