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Precautions and Warnings With Zalcitabine

There are several precautions and warnings with zalcitabine to be aware of before starting the medication. For example, zalcitabine can cause certain medical conditions (such as pancreatitis or nerve problems) and drug interactions. It is also possible that the drug may be passed through breast milk.

Zalcitabine: What Should I Tell My Healthcare Provider?

(This medication is no longer available. This medication was not discontinued for safety reasons. The manufacturer of zalcitabine chose to stop making it because current HIV treatment guidelines recommended using newer medications, rather than zalcitabine.)

 

You should talk with your healthcare provider prior to taking zalcitabine (Hivid®) if you have:
 
  • Congestive heart failure (CHF)
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Kidney disease, including kidney failure (renal failure)
  • Any allergies, including allergies to food, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
You should also be sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Zalcitabine

Some warnings and precautions to be aware of prior to taking zalcitabine include the following:
 
  • Zalcitabine can cause life-threatening inflammation of the pancreas (pancreatitis), which can be very dangerous. Let your healthcare provider know immediately if you have any signs of pancreatitis, such as:

 

    • A tender or swollen abdomen
    • Nausea and vomiting
    • Fever
    • A rapid heart rate (tachycardia)
    • Rapid breathing. 

 

  • Rarely, zalcitabine can cause lactic acidosis and hepatic steatosis. These medical conditions are caused by damage to the liver and can be very dangerous. You are at a higher risk for these conditions if you already have liver disease.
     
  • Zalcitabine can cause nerve problems (known as peripheral neuropathy). Often, these nerve problems cause unusual sensations, such as numbness, burning, or tingling. Be sure to let your healthcare provider know if you develop these nerve problems.
     
  • Zalcitabine can cause mouth or throat sores. These sores can become quite severe and may interfere with your ability to eat properly. Let your healthcare provide know if you develop severe mouth or throat sores.
     
  • There have been reports of congestive heart failure (CHF) in people taking zalcitabine. If you already have CHF, it is possible that zalcitabine can make your condition worse.
     
  • Zalcitabine appears to increase the risk of lymphoma (a certain cancer). Let your healthcare provider know if you develop a painless swelling in the neck, underarm, or groin (which may be a symptom of lymphoma).
     
  • The kidneys help remove zalcitabine from the body. If you have kidney disease, your healthcare provider may need to monitor you more closely and may recommend a lower zalcitabine dosage.
     
  • Zalcitabine can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and you may lose weight in other areas.
     
  • Zalcitabine is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, regardless of whether you are taking medications.
     
  • As with all HIV medications, it is important that you take zalcitabine exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
     
  • Zalcitabine can interact with a few different medications (see Drug Interactions With Zalcitabine for more information).
     
  • Zalcitabine is considered a pregnancy Category C medication. This means that zalcitabine may not be safe for use during pregnancy, although the full risks are not known (see Hivid and Pregnancy).
     
  • It is not known if zalcitabine passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Hivid and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
     

Zalcitabine Drug Information

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