Drug General Information (ID: DDIG5AFIU8)
Drug Name			Stavudine		Drug Info		Ribavirin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Antiviral Agents
Structure

Mechanism of Stavudine-Ribavirin Interaction (Severity Level: Moderate)
Attenuated pharmacological effects (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Stavudine				Ribavirin
Mechanism		Prodrug activated by intracellular phosphorylation				Intracellular phosphorylation inhibitor
Key Mechanism Factor 1
		Factor Name		Pharmacodynamics
		Factor Description		Reduced pharmacological effects leading to insufficient efficacy and/or treatment failure.
Mechanism Description		Attenuated pharmacological effects of  Stavudine when combined with Ribavirin

Recommended Action
Management		Coadministration of ribavirin with stavudine should be undertaken with caution and only if the benefit is anticipated to outweigh the potential risks. Patients should be advised to promptly seek medical attention if they experience symptoms of toxicity such as nausea, vomiting, abdominal pain/distention, fatigue, infection, unexplained weight loss, tachypnea, dyspnea, motor weakness, numbness, tingling, and pain in hands and feet. Dosage reduction or discontinuation of ribavirin should be considered if worsening toxicities are observed.

References
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3	Hoggard PG, Veal GJ, Wild MJ, Barry MG, Back DJ "Drug interactions with zidovudine phosphorylation in vitro." Antimicrob Agents Chemother 39 (1995): 1376-8. [PMID: 7574535]
4	Lafeuillade A, Hittinger G, Chadapaud S "Increased mitochondrial toxicity with ribavirin in HIV/HCV coinfection." Lancet 357 (2001): 280-1. [PMID: 11214134]
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6	Product Information. Copegus (ribavirin). Roche Laboratories, Nutley, NJ.
7	Product Information. Retrovir (zidovudine). Glaxo Wellcome, Research Triangle Park, NC.
8	Taburet AM, Singlas E "Drug interactions with antiviral drugs." Clin Pharmacokinet 30 (1996): 385-401. [PMID: 8743337]
9	Vogt MW, Hartshorn KL, Furman PA, et al. "Ribavirin antagonizes the effect of azidothymidine on HIV replication." Science 235 (1987): 1376-9. [PMID: 2435003]
10	Zylberberg H, Benhamou Y, Lagneaux JL, et al "Safety and efficacy of interferon-ribavirin combination therapy in HCV-HIV coinfected subjects: an early report." Gut 47 (2000): 694-7. [PMID: 11034587]