Drug Interactions between didanosine and emtricitabine / lopinavir / ritonavir / tenofovir

Talk to your doctor before using didanosine together with tenofovir. Combining these medications may increase the blood levels and effects of didanosine. This can increase the risk of serious side effects such as pancreatitis (inflammation of the pancreas), lactic acidosis (the buildup of lactic acid in the body), and peripheral neuropathy (nerve damage, particularly in the hands and feet). You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience nausea, vomiting, abdominal pain, fatigue, weight loss, loss of appetite, shortness of breath, muscle weakness, or numbness, tingling, or pain in the hands and feet. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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The following interaction applies only if you are taking lopinavir-ritonavir (brand name Kaletra) in a solution formulation:

didanosine should not be taken at the same time as lopinavir-ritonavir oral solution. This is because lopinavir-ritonavir oral solution must be taken with food to enhance absorption, whereas food interferes with the absorption of didanosine. You should take didanosine on an empty stomach one hour before or two hours after lopinavir-ritonavir oral solution. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Ritonavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Lopinavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Information for this minor interaction is available on the professional version.