Additive pancreatic
toxicity has occurred with the concurrent use of zalcitabine and
intravenous pentamidine, and a similar interaction is expected with didanosine or stavudine. Didanosine, stavudine and zalcitabine alone have all been associated with fatal
pancreatitis.
The manufacturers of zalcitabine recommend that if
pentamidine is needed, treatment with zalcitabine should be interrupted. A similar recommendation has been made for didanosine, although the manufacturers suggest that close monitoring is adequate. Careful monitoring is recommended if
pentamidine is given with stavudine.