A 30-year-old woman who was taking stavudine developed a rare side effect called lactic acidosis, which was successfully treated with intravenous thiamine.1 Controlled studies are needed to determine whether lactic acidosis might be prevented if people taking stavudine supplement with vitamin B1. Until more information is available, some health practitioners may recommend supplemental vitamin B1 to individuals taking stavudine.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Severe peripheral neuropathy (painful sensations due to nerve damage in the hands and feet) often develops in people taking stavudine or other drugs in its class. People with peripheral neuropathy who were taking one of these drugs were found to be deficient in acetyl-L-carnitine.2 In a preliminary trial, supplementing with 1,500 mg of acetyl-L-carnitine twice a day resulted in improvement in the neuropathy after six months in people taking stavudine or related drugs.3 Similar benefits were seen in another study that used the same amount of acetyl-L-carnitine.4
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
1. Schramm C, Wanitschke R, Galle PR. Thiamin for the treatment of nucleoside analogue-induced severe lactic acidosis. Eur J Anaesthesiol 1999;16:733–5.
2. Famularo G, Moretti S, Marcellini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS
3. Hart AM, Wilson ADH, Montovani C, et al. Acetyl-l-carnitine: a
pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy.
4. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV Clin Trials 2005;6:344–50.
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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