When used in combination with other drugs with similar toxicity, the risk of side effects increases.
Peripheral neuropathy is a serious and dose-dependent side effect of the drug. The risk of developing this effect increases with simultaneous use with didanosine. Peripheral neuropathy is usually accompanied by a bilateral symmetrical sense of numbness in the limbs: tingling and pain in the soles of the feet and less in the hands. In clinical trials, the frequency of these reactions depended on the dose and / or stage of the disease. In the early stages of the disease, these phenomena are less frequent.
Pancreatitis of various severity, including death, can develop in the patient at different stages of treatment and does not depend on whether the drug is administered as monotherapy or in combination with other drugs, or on the degree of immunosuppression.When using the drug in combination with didanosine or other drugs that have a toxic effect on the pancreas, the risk of developing pancreatitis increases.
Lactic Acidosis. Severe forms of steatosis with hepatomegaly, including death, are noted when nucleoside analogues are used in monotherapy or in combination with other antiviral drugs, including
stavudine. With the use of stavudine in combination with didanosine, the risk of liver dysfunction significantly increases. Nausea, vomiting, pain in the abdominal region, rapid breathing or shortness of breath, or muscle weakness may indicate the development of lactic acidosis.
Other side effects: thrombocytopenia, hepatitis, liver dysfunction, asthenia, headache, insomnia, dizziness; dry mouth, decreased appetite, diarrhea, pancreatitis; increased activity of "hepatic" transaminases, hyperbilirubinemia, neutropenia, allergic reactions (skin rash, fever), arthralgia, myalgia, chills.
Children: in clinical trials, the side effects of the drug in sick children and adults were similar.The development of peripheral neuropathy in children was less common than in adults. However, the symptoms of peripheral neuropathy in children were more difficult to identify.