Zalcitabine
Synonym(s)
DDC; Dideoxycytidine
Definition
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Half-life
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2 h
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Pharmacodynamics (Effect)
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Nucleoside analogue, competitive inhibition of the reverse transcriptase of the HI virus.
Indication
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Combination therapy of HIV infection.
Limited indication
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Restricted kidney function, pancreatitis or a history of elevated amylase levels.
Dosage and method of use
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- 3 times/day 0.75 mg p.o.
- creatinine clearance: 40-10 ml/min 0.75 mg twice a day.
- Creatinine clearance: < 10 ml/min: once/day 0.75 mg.
- Children: 3 times/day 0.015-0.03 mg/kg bw or 3 times/day 0.45-0.9 mg/m2 KO.
Undesirable effects
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Polyneuropathy, stomatitis, fever, nausea, allergic reactions, myelosuppression, pancreatitis.
Notice!
Stop taking Zalcitabine if polyneuropathic symptoms persist bilaterally for more than 2 days or if an earlier Achilles tendon reflex is no longer present or if symptoms suggest pancreatitis. Determination of serum amylase before starting therapy!
Interactions
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See Table 1.
Note! Do not use concomitant drugs that may cause peripheral neuropathy, such as DADPS, isoniazid, phenytoin and vincristine.
Contraindication
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Prenatal polyneuropathy.
Preparations
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Hivid
Patientinformation
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Patients must be informed about symptoms of a possible peripheral neuropathy and pancreatitis before starting therapy!
Tables
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Significant interactions of calcitabine
Aminoglycosides |
Zalcitabine toxicity ↑ |
amphotericin B |
Zalcitabine toxicity ↑ |
Chloramphenicol |
Risk of peripheral neuropathy ↑ |
Dapson |
Risk of peripheral neuropathy ↑ |
Didanosine |
CNS toxicity, avoid combination |
Disulfiram |
Risk of peripheral neuropathy ↑ |
Foscarnet |
Zalcitabine toxicity ↑ |
Isoniazid |
Risk of peripheral neuropathy ↑ |
Metronidazole |
Risk of peripheral neuropathy ↑ |
Nitrofurantoin |
Risk of peripheral neuropathy ↑ |
Pentamidine i.v. |
Pancreatitis risk ↑ Avoid combination |
Phenytoin |
Risk of peripheral neuropathy ↑ |
Ribavirin |
Risk of peripheral neuropathy ↑ |
Vincrist |
Risk of peripheral neuropathy ↑ |
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Prof. Dr. med. Peter Altmeyer