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Videx EC (didanosine) Disease Interactions

There are 8 disease interactions with Videx EC (didanosine):

Major

Ddi (Includes Videx EC) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Didanosine (ddI) is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for ddI-related toxicity due to decreased drug clearance. Therapy with ddI should be administered cautiously at reduced dosages in patients with renal impairment.

References

  1. Singlas E, Taburet AM, Lebas FB, et al "Didanosine pharmacokinetics in patients with normal and impaired renal function: influence of hemodialysis." Antimicrob Agents Chemother 36 (1992): 1519-24
  2. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nrtis (Includes Videx EC) ↔ Bone Marrow Suppression

Severe Potential Hazard, Moderate plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

The nucleoside reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC) and stavudine (d4T), may infrequently cause bone marrow suppression at recommended dosages. Anemia, leukopenia, thrombocytopenia and neutropenia have been reported. Therapy with these agents should be administered cautiously in patients with preexisting bone marrow depression or blood dyscrasias. Routine blood counts are recommended.

References

  1. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
  3. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
Major

Nrtis (Includes Videx EC) ↔ Hepatotoxicity

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Liver Disease

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has rarely been associated with the use of nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronouced hepatotoxicity occur.

References

  1. Dolin R, Lambert JS, Morse GD, et al "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  2. Montaner JSG, Rachlis A, Beaulieu R, Gill J, Schlech W, Phillips P, Auclair C, Boulerice F, Schindzielorz A, Smaldone L, Wainber "Safety profile of didanosine among patients with advanced HIV disease who are intolerant to or deteriorate despite zidovudine therapy: results of the canadian open ddi treatment program." J Acquir Immune Defic Syndr 7 (1994): 924-30
  3. Yarchoan R, Mitsuya H, Pluda JM, et al "The National Cancer Institute phase I study of 2',3'-dideoxyinosine administration in adults with AIDS-related complex: analysis of activity and toxicity profiles." Rev Infect Dis 12 (1990): s522-33
View all 22 references
Major

Nrtis (Includes Videx EC) ↔ Pancreatitis

Severe Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia, Pancreatitis, Alcoholism

The reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC), stavudine (d4T) and lamivudine (3TC), may cause pancreatitis. The incidence is generally low but is approximately 7% with ddI, and up to 15% in pediatric patients given 3TC. Patients with a history of or known risk factors for pancreatitis, such as alcohol abuse or hypertriglyceridemia, should be monitored closely during therapy with these agents. Therapy should be discontinued at the first signs or symptoms suggestive of pancreatitis (e.g., nausea, vomiting, abdominal pain, hyperamylasemia with dysglycemia, rising triglycerides, decreasing serum calcium), and preferably permanently discontinued if clinical pancreatitis develops.

References

  1. van Leeuwen R, Katlama C, Kitchen V, Boucher CA, Tubiana R, McBride M, Ingrand D, Weber J, Hill A, McDade H, et al "Evaluation of safety and efficacy of 3TC (lamivudine) in patients with asymptomatic or mildly symptomatic human immunodeficiency virus infection: a phase I/II study." J Infect Dis 171 (1995): 1166-71
  2. Dolin R, Lambert JS, Morse GD, et al "2',3'-dideoxyinosine in patients with AIDS or AIDS-related complex." Rev Infect Dis 12 (1990): s540-51
  3. "Product Information. Zerit (stavudine)." Bristol-Myers Squibb, Princeton, NJ.
View all 18 references
Major

Nrtis (Includes Videx EC) ↔ Peripheral Neuropathy

Severe Potential Hazard, High plausibility

Applies to: Peripheral Neuropathy

The nucleoside reverse transcriptase inhibitors, didanosine (ddI), zalcitabine (ddC), and stavudine (d4T), may commonly cause dose-related peripheral neuropathy, particularly in patients with advanced HIV disease. Usually, the neuropathy resolves slowly following prompt discontinuation of therapy, but it can be irreversible. These agents should be administered cautiously to patients with a history of neuropathy and avoided in patients with existing polyneuropathy. Therapy may be reinstituted following resolution of symptoms in patients who have previously experienced neuropathy with these drugs, but reduced dosages are recommended.

References

  1. Whittington R, Brogden RN "Zalcitabine: a review of its pharmacology and clinical potential in acquired immunodeficiency syndrome (AIDS)." Drugs 44 (1992): 656-83
  2. Moore RD, Fortgang I, Keruly J, Chaisson RE "Adverse events from drug therapy for human immunodeficiency virus disease." Am J Med 101 (1996): 34-40
  3. "Product Information. HIVID (zalcitabine)." Roche Laboratories, Nutley, NJ.
View all 12 references
Moderate

Ddi (Includes Videx EC) ↔ Hyperuricemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Gout

Didanosine (ddI) may infrequently cause hyperuricemia. Patients with preexisting hyperuricemia or gout should be monitored for exacerbation of condition during ddI therapy.

References

  1. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
  2. Mehlhaff DL, Stein DS "Gout secondary to ritonavir and didanosine." AIDS 10 (1996): 1744
  3. Schindzielorz A, Pike I, Daniels M, Pacelli L, Smaldone L "Rates and risk factors for adverse events associated with didanosine in the expanded access program." Clin Infect Dis 19 (1994): 1076-83
View all 4 references
Moderate

Ddi (Includes Videx EC) ↔ Pku

Moderate Potential Hazard, High plausibility

Applies to: Phenylketonuria

Videx (brand of didanosine, or ddI) chewable/dispersable buffered tablets contain 36.5 mg of phenylalanine per each 25, 50, 100, and 150 mg tablet. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

References

  1. "Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Ddi (Includes Videx EC) ↔ Sodium

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction, Congestive Heart Failure, Hypernatremia, Hypertension, Fluid Retention

Didanosine (ddI) formulations have a high sodium content. There are 265 mg of sodium per tablet and 1380 mg per packet of powder for oral solution, which may be of concern in patients with conditions that may be adversely affected by excessive amounts of sodium, such as congestive heart failure, hypertension, and fluid retention. Each tablet also contains 8.6 mEq of magnesium. Patients with significant renal impairment may not tolerate these loads.

References

  1. Schindzielorz A, Pike I, Daniels M, Pacelli L, Smaldone L "Rates and risk factors for adverse events associated with didanosine in the expanded access program." Clin Infect Dis 19 (1994): 1076-83
  2. Willocks L, Brettle R, Keen J "Formulation of didanosine (ddI) and salt overload." Lancet 339 (1992): 190
  3. Pike IM, Nicaise C "The didanosine Expanded Access Program: safety analysis." Clin Infect Dis 16 (1993): S63-8

Videx EC (didanosine) drug Interactions

There are 287 drug interactions with Videx EC (didanosine)

Videx EC (didanosine) alcohol/food Interactions

There are 3 alcohol/food interactions with Videx EC (didanosine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

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