Microsoft word - didanosine.doc


Didanosine is an antiviral treatment in a class of drugs called nucleoside
reverse transcriptase inhibitors (NRTI). This medication is used in
combination with other medications to treat people with HIV (human
immunodeficiency virus) infection. This medication is not a cure for
HIV or AIDS (acquired immune deficiency syndrome) but may slow the
progress of the disease if used correctly.
AVAILABLE AS: Videx chew/dispersible buffered tablet in 25, 50, 100,
150, and 200 milligrams (mg). Videx buffered powder for oral solution in
packets of 100, 167, and 250 mg. Videx pediatric pwdr for oral solution in
4 and 8 ounce bottles of 2 or 4 grams respectively (10mg/ml). Videx EC
delayed-release caps in 125, 200, 250 and 400 mg
It is important to use this medication exactly as directed by your doctor. Do not stop
taking your medication without consulting your physician first. Didanosine comes in
various dosage forms including a delayed release capsule, chewable tablets, powder and
oral liquids. All forms of the medication should be taken on an empty stomach at least an
hour before or two hours after meals.
The delayed-release capsules should be taken only once a day and swallowed whole. Do
not crush, chew, break or open these capsules. Chew the chewable tablets before
swallowing them. These tablets can be dissolved in one ounce of water (2 tablespoons)
and must be consumed right away. Two tablespoons of clear apple juice may be added to
the water to add flavor. Do not add any other types of liquid. Drink this solution right
away to maintain stability. Mix the powder with four ounces (half a glass) of water. Stir
this mixture until it is completely dissolved and drink it right away. Other liquids
including apple juice may not be added to this product.
The oral liquid should be measured with a measuring device to obtain the most accurate
dose. This product must be shaken every time before use and kept in the refrigerator. Do
not freeze. After 30 days the liquid form of this medication must be thrown away.
Store your medication (other than the liquid) in a cool, dry place away from excessive
heat, cold, light or moisture. Keep medication out of the reach of children.
It is very important to take every dose of your medication in order for it to work
correctly. If you do miss a dose of didanosine, take it as soon as you remember unless it
is close to your next dose. Do not take two doses at once. If you think you may have
taken too much of your medication, contact your local poison control center or
emergency room right away.
Do not use didanosine if you are allergic to didanosine or any of its components.
Common side effects that most likely will go away with time include headache, mild
nausea, vomiting, upset stomach, diarrhea, or decreased appetite, and dryness of the
mouth or eyes. Other side effects you should talk to your doctor about include a rash or
redistribution of body fat. This may include increased fat around the upper neck and
back, breasts, trunk and abdomen. Loss of fat from the arms, legs and face may also
occur. Talk to your doctor about ways to manage these side effects with diet, exercise or
Warning: Contact you doctor immediately if you experience any of the conditions
listed below.
Stop taking didanosine and seek medical attention immediately if you
experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the
lips, tongue or face; or hives). Pancreatitis (inflammation of the pancreas) is also a
severe side effect that may include symptoms of nausea, vomiting, diarrhea, and
abdominal pain. This condition can be aggravated by alcohol use and therefore should be
avoided. Signs of a severe condition called peripheral neuropathy (nerve damage)
include numbness, loss of feeling, or tingling or pain in the hands or feet. Lactic acidosis
or liver disease is also a rare but serious side effect of didanosine. Symptoms of this may
include yellowing of the skin or eyes, nausea, vomiting, shortness of breath, weakness,
abdominal pain or discomfort, bloating, tenderness, unusual bleeding or bruising, or
severe fatigue. Other serious side effects include fever, chills, visual changes (decreased
vision, blindness, eye pain, or changes in eye color), or suddenly slow or irregular
heartbeat. Notify your doctor if you currently have or have had any of the following
conditions in the past: phenylketonuria (PKU), gout, pancreas problems, or kidney or
liver disease. Also report any past or present nerve problems or medications that you are
taking that may affect your nerves.

Notify your doctor if you are pregnant, planning to become pregnant or breastfeeding.
Didanosine’s effects on an unborn baby are still unclear. People with HIV should never
breastfeed because of the risk of transmitting HIV to the infant.
This medication does not prevent the transmission of HIV to other people. Make sure
you understand and practice safe sex and do not share needles with anyone.
Most formulations of didanosine have an antacid to protect the drug from the acidic
environment of your stomach. Therefore additional antacids should be separated from
your dose of didanosine by at least two hours. The buffered form of didanosine can
change the effectiveness of certain antibiotics which should not be taken within two to
four hours of taking didnosine. Separate the following drugs from didanosine by at lease
two to four hours: tetracycline (Sumycin, Terramycin), doxycycline (Doryx,
Vibramycin), minocycline (Minocin), Ciprofloxacin (Cipro), enoxacin (Penetrex),
gatifloxacin (Tequin), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin
(Avelox), ofloxacin (Floxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and
norfloxacin (Noroxin). It is recommended that didanosine be used in combination with
other anti-HIV medication. However, some of these medications may change how
didanosine works in your body and may need the dose to be adjusted or should be
separated from your dose of didanosine. These include indinavir (Crixivan), delavirdine
(Rescriptor), nelfinavir (Viracept), ritonavir (Norvir), and tenofovir (Viread). Certain
antifungal medication need to be given in an acidic environment and should be avoided
or separated from you didanosine dose by at least two hours. These include ketoconazole
(Nizoral) and itraconazole (Sporanox). Other medications to avoid include allopurinol
(Zyloprim), methadone and ribavirin (Rebetol, Rebetron). Ask your doctor or
pharmacist about any medications including over the counter, herbal, vitamin, and
prescription products before using them with didanosine.
References: see references 16-20


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