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Drug Interactions between Retrovir and Videx

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

zidovudine didanosine

Applies to: Retrovir (zidovudine) and Videx (didanosine)

In one study, concomitant use of zidovudine and didanosine increased zidovudine elimination half-life by 18% and increased the area under the plasma concentration-time curve by 35%. However, several other studies (including one pediatric study) failed to demonstrate significant pharmacokinetic alterations of either drug when zidovudine and didanosine were administered concurrently. A consistent pharmacokinetic interaction does not appear to exist between these two drugs, but it may be appropriate to monitor for increased toxicities during simultaneous therapy.

References

  1. Sim SM, Back DJ, Breckenridge AM (1991) "The effect of various drugs on the glucuronidation of zidovudine (azidothymidine; AZT) by human liver microsomes." Br J Clin Pharmacol, 32, p. 17-21
  2. Knupp CA, Milbrath R, Barbhaiya RH (1993) "Effect of time of food administration on the bioavailbility of didanosine from a chewable tablet formulation." J Clin Pharmacol, 33, p. 568-73

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Drug and food interactions

Moderate

didanosine food

Applies to: Videx (didanosine)

ADJUST DOSING INTERVAL: Didanosine bioavailability is decreased when administered with food. Loss of efficacy may result.

MANAGEMENT: Didanosine should be administered in the fasting state, at least 30 minutes before or more than 2 hours after eating.

References

  1. (2002) "Product Information. Videx (didanosine)." Bristol-Myers Squibb

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Minor

zidovudine food

Applies to: Retrovir (zidovudine)

Food may have variable effects on the oral bioavailability of zidovudine. Fatty foods have been reported to decrease the rate and extent of zidovudine absorption following oral administration. In a study of 13 AIDS patients, mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of zidovudine were 2.8 and 1.4 times higher, respectively, in fasting patients than in those administered the medication with breakfast. In addition, variations in plasma zidovudine concentrations were increased when administered in the fed state. In another study of eight patients, the time to reach peak concentration (Tmax) was increased from 0.68 to 1.95 hours, and Cmax was reduced by 50% when zidovudine was administered with a liquid high-fat meal relative to fasting. Protein meals can also delay the absorption and reduce the Cmax of zidovudine, although the extent of absorption is not significantly affected. The clinical significance of these alterations, if any, is unknown. The product labeling states that zidovudine may be taken with or without food.

References

  1. Lotterer E, Ruhnke M, Trautman M, et al. (1991) "Decreased and variable systemic availability of zidovudine in patients with AIDS if administered with a meal." Eur J Clin Pharmacol, 40, p. 305-8
  2. Unadkat JD, Collier AC, Crosby SS, et al. (1990) "Pharmacokinetics of oral zidovudine (azidothymidine) in patients with AIDS when administered with and without a high-fat meal." AIDS, 4, p. 229-32
  3. (2001) "Product Information. Retrovir (zidovudine)." Glaxo Wellcome
  4. Sahai J, Gallicano K, Garber G, et al. (1992) "The effect of a protein meal on zidovudine pharmacokinetics in HIV-infected patients." Br J Clin Pharmacol, 33, p. 657-60
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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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