[e-drug] Stavudine in Paediatric ART?

e-drug
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E-DRUG: Stavudine in Paediatric ART?
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Dear E-druggers,

In the new Namibian ART guidelines for children zidovudine (AZT) has been replaced by stavudine (d4T) as the medicine of choice for firstline treatment. This is change has been made because the government has received a donation of dispersable fixed dose combination (FDC) tablets through the Bill Clinton Foundation. These FDC's will be particularly used for smaller children who cannot yet swallow solid dosage forms and are given oral liquids. There will two strengths of dual FDC's (stavudine and lamivudine) and two strengths of triple FDC's (stavudine, lamivudine, and nevirapine).

Are there other countries where stavudine is routinely used as firstline treatment in paediatrics and what is the experience with this medicine?

Best regards Fritz Steinhausen

--
Karl F. Steinhausen
Pharmacist
ART Clinic, Keetmanshoop State Hospital
P.O.Box 93
Keetmanshoop - NAMIBIA

ph: +264-63-22 55 23
mobile: +264-81-22 11 379
e-mail: kfsteinhausen@gmx.net

[I just wonder whether it is wise to change your treatment guidelines because you can get something else for free? Is it not a principle in the WHO donation guidelines that donors should adapt to the country's needs (as expressed in their STGs) rather than vice-versa? Just a side comment from your moderator... WB]

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E-DRUG: Stavudine in Paediatric ART? (2)
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Dear All,

I am keen to learn two things about the paediatric FDC.

1) Is there any bioequivalence data compared with single formulations? The
premise for asking this is the fact that for adults, the stavudine
bioavalabilty was higher than single formulations thus toxicity was
reported very early.

2) What options are given for children who develop TB when on the FDC?
Particularly those less than 5 years?

Thanks,

Jonathan Mwiindi
EPN
epn@wananchi.com