Zalcitabine (ddC, Hivid, dideoxycytidine)


+

On June 6, 1992, Food and Drug Administration (FDA) HHS Secretary Louis W. Sullivan, M.D., announced that the FDA had approved the AIDS drug Zalcitabine or ddC. It is the third drug licensed specifically for treatment of human immunodeficiency virus. Dr. Sullivan said, "This drug approval represents another step forward for patients with AIDS. Zalcitabine has been rapidly developed, tested and reviewed through the cooperative efforts of scientists in the National Institutes of Health and FDA, academia and the pharmaceutical industry."

James Mason, M.D., quickly pointed out, though, that, "This new drug is not a cure, but it constitutes an important addition to the expanding group of antiviral drugs currently available, including AZT and DDI, for treating people with AIDS."

+ Description: ddC is a nucleoside analog drug designed to treat HIV. The pharmacological action of zalcitabine is to prevent the AIDS virus from replicating or reproducing before T-Cells (immune cells) are infected. Specifically, dideoxynucleoside analogs inhibit reverse transcriptase by terminating replication. Replication is terminated when an analog is incorporated into a growing DNA molecule because the 3'OH of the sugar has been removed, thereby precluding chain extension (see structure above).

+ Side Effects: Serious side effects include neurological complications (slight tingling and/or pain in the hands and feet). Inflammation of the nerves is called peripheral neuropathy and is a serious side effect. Symptoms include a burning or numbing in he hands or feet. Severity can vary from mild symptoms to a serious pain that makes walking hard. This condition usually vanishes when Zalcitabine is no longer taken. Other side effects include: pancreatitis, rash, oral ulcers, decreased blood platelet counts, abnormal liver function, skin eruptions, canker sores, and fever.

+ Managing Side Effects: If neuropathy results, drug usage must be discontinued. Antidepressants seem to alleviate peripheral neuropathy. Alternative medicine, such as acupuncture, also seems to help some.

+ Dosage: Adults take 2.25 mg a day total. This is taken in three doses that should be divided evenly and spaced evenly throughout the day.

+ Efficacy: The drug must be taken constantly to control an infection to prevent illness. If viral resistance builds and you become resistant, Zalcitabine usage may be discontinued.

+ Price: For 100 .75mg Tablets (3/day, lasting approximately 33 days), Hivid (Zalcitabine) costs $198.76. (www.planetrx.com)

+ Studies: Viani RM. "HIV Phenotypes in Children Treated with Zalcitabine." J Infect Dis. 1998; 177: 565-570.
Viani et al. Showed that zalcitabine resistance in children is rare despite prolonged treatment.



References used:
+ http://www.aidsinfonyc.org/network/access/drugs/zalc.html
+ http://www.aidsinfonyc.org/network/simple/zalc.html
+ http://www.fda.gov/bbs/topics/NEWS/NEW00283.html
+ http://www.iapac.org/clinmgt/abstracts/pedpheno.html
+ http://www.niaid.nih.gov/daids/dtpdb/000006.htm


Last modified: Mon Mar 6 05:57:24 PST 2000