"The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has recommended 150 mg lamivudine/300 mg raltegravir (Dutrebis, Merck Sharp & Dohme Limited) for the treatment of HIV 1 infection in adults, adolesce"...
DOSAGE AND ADMINISTRATION
The interval between doses of ZERIT (stavudine) should be 12 hours. ZERIT may be taken with or without food.
Recommended Adult Dosage
The recommended adult dosage is based on body weight as follows:
- For patients weighing less than 60 kg: 30 mg every 12 hours.
- For patients weighing at least 60 kg: 40 mg every 12 hours.
Recommended Pediatric Dosage
- For newborns from birth to 13 days old: 0.5 mg/kg given every 12 hours.
- For pediatric patients at least 14 days old and weighing less than 30 kg: 1 mg/kg given every 12 hours.
- For pediatric patients weighing at least 30 kg: use the recommended adult dosage.
Adult Patients: ZERIT may be administered to adult patients with impaired renal function with an adjustment in dosage as shown in Table 1.
Table 1: Recommended Dosage Adjustment for Adult Patients
with Renal Impairment
|Creatinine Clearance (mL/min)||Recommended ZERIT Dose by Patient Weight|
|at least 60 kg||less than 60 kg|
|greater than 50||40 mg every 12 hours||30 mg every 12 hours|
|26–50||20 mg every 12 hours||15 mg every 12 hours|
|10–25||20 mg every 24 hours||15 mg every 24 hours|
|Hemodialysis||20 mg every 24 hours *||15 mg every 24 hours *|
|*Administered after the completion of hemodialysis on dialysis days and at the same time of day on non-dialysis days.|
Pediatric Patients: Since urinary excretion is also a major route of elimination of stavudine in pediatric patients, the clearance of stavudine may be altered in children with renal impairment. There are insufficient data to recommend a specific dose adjustment of ZERIT in this patient population.
Method of Preparation for Oral Solution
Prior to dispensing, the pharmacist must constitute the dry powder with purified water to a concentration of 1 mg stavudine per mL of solution, as follows:
- Add 202 mL of purified water to the container.
- Shake container vigorously until the powder dissolves completely. Constitution in this way produces 200 mL (deliverable volume) of 1 mg/mL stavudine solution. The solution may appear slightly hazy.
- Dispense solution in original container with measuring cup provided. Instruct patient to shake the container vigorously prior to measuring each dose and to store the tightly closed container in a refrigerator, 2°C to 8°C (36°F to 46°F). Discard any unused portion after 30 days.
Dosage Forms And Strengths
- ZERIT 15 mg capsules with dark red cap and light yellow body, printed with black ink “BMS 1964” on the cap and with black ink “15” on the body.
- ZERIT 20 mg capsules with light brown cap and light brown body, printed with black ink “BMS 1965” on the cap and with black ink “20” on the body.
- ZERIT 30 mg capsules with dark orange cap and light orange body, printed with black ink “BMS 1966” on the cap and with black ink “30” on the body.
- ZERIT 40 mg capsules with dark orange cap and dark orange body, printed with black ink “BMS 1967” on the cap and with black ink “40” on the body.
- ZERIT for oral solution is a dye-free, fruit-flavored powder that provides 1 mg of stavudine per milliliter solution after constitution.
Storage And Handling
ZERIT® (stavudine) Capsules are available in the following strengths and configurations of plastic bottles with child-resistant closures:
Table 13: Capsule Strength/Configuration
|Product Strength||Capsule Shell Color||Markings on Capsule(in Black Ink)||Capsules per Bottle||NDC No.|
|15 mg||Light yellow & dark red||BMS1964||15||60||0003-1964-01|
|20 mg||Light brown||BMS1965||20||60||0003-1965-01|
|30 mg||Light orange & dark orange||BMS1966||30||60||0003-1966-01|
|40 mg||Dark orange||BMS1967||40||60||0003-1967-01|
ZERIT® (stavudine) for Oral Solution is a dye-free, fruit-flavored powder that provides 1 mg of stavudine per mL of solution upon constitution with water. Directions for solution preparation are included on the product label and in the Dosage and Administration (2) section of this insert. ZERIT for Oral Solution (NDC No. 0003-1968-01) is available in child-resistant containers that provide 200 mL of solution after constitution with water.
ZERIT Capsules should be stored in tightly closed containers at 25°C (77°F). Excursions between 15°C and 30°C (59°F and 86°F) are permitted (see USP Controlled Room Temperature).
ZERIT for Oral Solution should be protected from excessive moisture and stored in tightly closed containers at 25°C (77°F). Excursions between 15°C and 30°C (59°F and 86°F) are permitted (see USP Controlled Room Temperature). After constitution, store tightly closed containers of ZERIT for Oral Solution in a refrigerator, 2°C to 8°C (36°F to 46°F). Discard any unused portion after 30 days.
Distributed by: Bristol-Myers Squibb Company Princeton, NJ 08543 USA. Rev November 2011
Last reviewed on RxList: 12/6/2011
This monograph has been modified to include the generic and brand name in many instances.
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