Stavudine (SVD)

Stavudine is a nucleoside analog reverse-transcriptase inhibitor (NARTI) active against HIV. Stavudine is an analog of thymidine. It is phosphorylated by cellular kinases into active triphosphate.

Stavudine triphosphate inhibits the HIV reverse transcriptase by competing with natural substrate, thymidine triphosphate. It also causes termination of DNA replication by incorporating into the DNA strand. Simultaneous use of zidovudine is not recommended, as it can inhibit the intracellular phosphorylation of stavudine. Other anti-HIV drugs do not possess this property. The main severe adverse effect is peripheral neuropathy, which can be corrected by reducing dosage. Stavudine has been shown in laboratory test to be genotoxic, but with clinical doses its carcinogenic effects are non-existent.