Stavudine Fluconazole

Drugs that may affect zidovudine include acetaminophen, atovaquone, bone marrow suppressive/cytotoxic agents (eg, adriamycin, dapsone), clarithromycin, doxorubicin, fluconazole, ganciclovir, methadone, nelfinavir/ritonavir, phenytoin, probenecid, ribavirin, rifamycins, stavudine, trimethoprim, and valproic acid. 

A 35-year old Caucasian man with AIDS and multiple opportunistic infections, including Mycobacterium kansasii and Mycobacterium avium complex (MAC) disease developed moderate to severe primary sensorineural hearing loss after 4—5 months of therapy with oral azithromycin 500 mg/day. Other medications included ethambutol, isoniazid, rifabutin, ciprofloxacin, co-trimoxazole, fluconazole, zidovudine (later switched to stavudine), lamivudine, indinavir, methadone, mod-ified-release oral morphine, pseudoephedrine, diphenhydramine, megestrol acetate, trazodone, sorbitol, salbutamol by metered-dose inhaler and nebulizer, ipratropium, and oral morphine solution as needed. Significant improvement of the hearing impairment was documented 3 weeks after drug withdrawal. 

Fluconazole has no significant effect on the pharmacokinetics of didanosine or stavudine, but it may cause an increase in serum zidovudine levels although the clinical importance of this is uncertain. Fluconazole serum levels remain unchanged. 

A study in 10 HIV-positive subjects taking stavudine 40 mg twice daily, found that the addition of fluconazole 200 mg daily for one week had no significant effect on the pharmacokinetics of the stavudine. ... 

There is no pharmacokinetic interaction between stavudine and fluconazole. No interaction would be expected with other similar NRTIs such as lamivudine and zalcitabine (see Antivirals , (p.772)). 

Class 1 (High Permeability, High Solubihty) Albuterol, Allopurinol, Amlodipine (Amlo), AmoxicilUn, Antipyiine, Dexamethasone, Diltiazem, Zidovudine, Isosoibide mononitrate, Ketoprofen, Lamivudine, Levonoigestiel, Levofloxa-cin. Metronidazole, Midazolam, Minocycline, Morphine, Nifedipine, Ofloxacin, Prednisolone, Propylthiouracil, Stavudine, Phenobaibital, Fluconazole, Chiiiin, Enalapril, Acetaminophen, Diazepam, Lsoniazid, Levodopa, Metoprolol, Paracetamol, Pyrazinamide, Salicylic add, Ethirtylestradiol. ... 

Simultaneous didanosine, folic acid, ganciclovir, lamivudine, nevirapine, pyrazinamide, ranitidine, rifampin, stavudine, sulfamethoxazole, trimethoprim, zidovudine Noninterfering adefovir, amprenavir, delavirdine, efavirenz, fluconazole, indinavir, itraconazole, methadone, nelfinavir, oxazepam, pyrimethamine, rifampin, ritonavir, saquinavir, zalcitabine... 

Noninterfering acetaminophen, amineptine, amphotericin B, aspirin, bromazepam, buspirone, citalopram, clobazam, diazepam, didanosine, fluconazole, flunitrazepam, flu-voxamine, hydroxyitraconazole, isoniazid, itraconazole, lamivudine, loprazolam, lora-zepam, metronidazole, minalcipram, nordiazepam, omeprazole, paroxetine, pyrimethamine, rifampin, sertraline, stavudine, sulfadiazine, trimethoprim, venlafaxine, zal-citabine, zidovudine, zolpidem, zopiclone... 

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