Drug General Information (ID: DDI6HG5J2U)
Drug Name			Zalcitabine		Drug Info		Amiodarone		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Antiarrhythmic Agents
Structure

Mechanism of Zalcitabine-Amiodarone Interaction (Severity Level: Moderate)
Increased risk of peripheral neuropathy Click to Show/Hide Mechanism Graph
Drug Name		Zalcitabine				Amiodarone
Mechanism		Peripheral neuropathy				Peripheral neuropathy
Key Mechanism Factor 1
		Factor Name		Peripheral neuropathy
		Factor Description		Peripheral neuropathy is a disorder of the peripheral nerves that can cause sensory and motor symptoms, and even paralysis in severe cases. Signs and symptoms of peripheral neuropathy may include: gradual numbness, tingling or prickling in the feet or hands that can spread up the legs and arms; sharp, stinging, pricking or burning sensations; extreme sensitivity to touch; pain during activities that should not cause pain; lack of coordination and falls; muscle weakness; and paralysis if the motor nerves are affected.
Mechanism Description		Increased risk of peripheral neuropathy by the combination of Zalcitabine and Amiodarone

Recommended Action
Management		Use of zalcitabine with other drugs that have the potential to cause peripheral neuropathy should be avoided whenever possible. Otherwise, careful monitoring is recommended for symptoms of neuropathy such as burning, tingling, pain, numbness, or weakness in the extremities, particularly in patients with a low CD4 cell count or diabetes. Since the development of peripheral neuropathy appears to be dose-related, the recommended dosage of zalcitabine should not be exceeded. Patients should be advised to promptly discontinue zalcitabine therapy and contact their physician if neuropathy develops. Therapy may be reinstituted following resolution of neuropathy symptoms, but dosage should be reduced to one-half the initially recommended dosage. Zalcitabine should be permanently discontinued in patients who develop severe peripheral neuropathy during treatment.

References
1	Argov Z, Mastaglia FL "Drug-induced peripheral neuropathies." Br Med J 1 (1979): 663-6. [PMID: 219931]
2	Product Information. Hivid (zalcitabine). Roche Laboratories, Nutley, NJ.