Stavudine; Zidovudine/Ribavirin Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Ribavirin may decrease the transformation of stavudine and zidovudine to their active forms.

What might happen:

The levels of the active forms of stavudine and zidovudine in your blood may decrease and it may not be as effective.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your medicine may need to be changed.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Hoggard PG, Veal GJ, Wild MJ, Barry MG, Back DJ. Drug interactions with zidovudine phosphorylation in vitro. Antimicrob Agents Chemother 1995 Jun; 39(6):1376-8.
  • 2.Hoggard PG, Kewn S, Barry MG, Khoo SH, Back DJ. Effects of drugs on 2',3'-dideoxy-2',3'-didehydrothymidine phosphorylation in vitro. Antimicrob Agents Chemother 1997 Jul;41(6):1231-6.
  • 3.Stotka RA. Personal communication. Glaxo Wellcome, Inc. June 1, 2000. 4.Copegus (ribavirin) US prescribing information. Roche Laboratories, Inc. August, 2015.
  • 4.Retrovir (zidovudine) US prescribing information. GlaxoSmithKline September, 2018.
  • 5.Rebetol (ribavirin) US prescribing information. Merck & Co., Inc. May, 2019.
  • 6.Zerit (stavudine) US prescribing information. Bristol-Myers Squibb Company December 19, 2017.
  • 7.Sim SM, Hoggard PG, Sales SD, Phiboonbanakit D, Hart CA, Back DJ. Effect of ribavirin on zidovudine efficacy and toxicity in vitro: a concentration-dependent interaction. AIDS Res Hum Retroviruses 1998 Dec 20;14(18):1661-7.
  • 8.Baba M, Pauwels R, Balzarini J, Herdewijn P, De Clercq E, Desmyter J. Ribavirin antagonizes inhibitory effects of pyrimidine 2',3'- dideoxynucleosides but enhances inhibitory effects of purine 2',3'- dideoxynucleosides on replication of human immunodeficiency virus in vitro. Antimicrob Agents Chemother 1987 Oct;31(10):1613-7.
  • 9.Vogt MW, Hartshorn KL, Furman PA, Chou TC, Fyfe JA, Coleman LA, Crumpacker C, Schooley RT, Hirsch MS. Ribavirin antagonizes the effect of azidothymidine on HIV replication. Science 1987 Mar 13;235(4794):1376-9.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.