The combination of d4T (stavudine, Zerit) with AZT (zidovudine, Retrovir) is antagonistic, with each drug reducing the two drugs’ combined anti-HIV effects^[1]. Consequently, this combination is not recommended.

Taking the hepatitis C treatment ribavirin (Copegus / Rebetol / Virazole) when also taking d4T may increase the risk of a set of side-effects associated with elevated lactate including the rare, life-threatening condition lactic acidosis^[2]. It may also increase the risk of body fat loss^[3]. Test-tube studies also suggest that ribavirin and doxorubicin (Caelyx / Myocet) may block the production of the active form of d4T in the body, reducing the drug’s anti-HIV effects.

Caution should be used when d4T is taken with other drugs that may cause peripheral neuropathy. These include:

• Chloramphenicol (Kemicetine).
• Cisplatin (Platinex)
• Dapsone.
• ddC (zalcitabine, Hivid).
• ddI (didanosine, Videx / VidexEC).
• Ethambutol.
• Ethionamide.
• Hydralazine (Aprelosine).
• Isoniazid.
• Lithium (Camcolit / Liskonum / Priadel).
• Metronidazole (Flagyl / Flagyl S / Metrolyl).
• Nitrofurantoin (Furadantin / Macrobid / Macrodantin).
• Phenytoin (Epanutin).
• Vincristine (Oncovin).