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didanosine

Generic Name: didanosine (dye DAN oh seen)
Brand Name: Videx, Videx EC

What is didanosine?

Didanosine is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in your body.

Didanosine is used to treat HIV, the virus that can cause acquired immunodeficiency syndrome (AIDS). Didanosine is not a cure for HIV or AIDS.

Didanosine is for use in adults and children who are at least 2 weeks old.

Didanosine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about didanosine?

Do not take didanosine together with allopurinol or ribavirin.

Didanosine may cause a serious condition called lactic acidosis. Get emergency medical help if you have even mild symptoms such as: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

This medicine can also cause severe or life-threatening effects on your liver or pancreas. Call your doctor at once if you have: severe pain in your upper stomach (may spread to your back), nausea and vomiting, fast heart rate, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

What should I discuss with my healthcare provider before taking didanosine?

You should not use didanosine if you are allergic to it.

Do not take didanosine together with allopurinol (Zyloprim, Lopurin, Aloprim) or ribavirin (Rebetol, Ribasphere, Copegus, Virazole).

Some people taking didanosine develop a serious condition called lactic acidosis. This may be more likely in women, in people who are overweight or have liver disease, and in people who have taken HIV/AIDS medication for a long time. Talk with your doctor about your risk.

To make sure didanosine is safe for you, tell your doctor if you have:

  • liver disease or a history of pancreatitis (didanosine can cause severe or life-threatening effects on your liver or pancreas);

  • kidney disease;

  • a history of numbness or tingling in your hands or feet, including Raynaud's syndrome;

  • if you drink large amounts of alcohol; or

  • if you also take stavudine (Zerit).

If you are pregnant, do not take didanosine together with stavudine. This combination of medicines can cause lactic acidosis or liver problems, which can be very dangerous during pregnancy.

HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection. Your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of didanosine on the baby.

Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How should I take didanosine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take didanosine on an empty stomach, at least 30 minutes before or 2 hours after a meal. Do not take with food.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, break, or open a delayed-release capsule. Swallow it whole.

HIV/AIDS is usually treated with a combination of drugs, but certain HIV medications or antibiotics should not be taken at the same time as didanosine. These other medicines can affect the levels of didanosine in your blood stream:

  • Ciprofloxacin (Cipro) should be taken at least 2 hours before or 6 hours after you take didanosine.

  • Delavirdine (Rescriptor) or indinavir (Crixivan) should be taken at least 1 hour before you take didanosine.

  • Nelfinavir (Viracept) should be taken at least 1 hour after you take didanosine.

  • Itraconazole (Sporanox) or ketoconazole (Nizoral) should be taken at least 2 hours before you take didanosine.

Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

While using didanosine, you may need frequent blood tests. Your vision, kidney function, and liver function may also need to be checked.

Store the tablets or capsules at room temperature in a tightly closed container, away from moisture and heat.

Store the liquid form of didanosine in the refrigerator. Throw away any leftover didanosine liquid that is more than 30 days old.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking didanosine?

Do not drink alcohol. It may increase your risk of liver damage or pancreatitis.

Avoid using antacids without your doctor's advice while taking didanosine. Use only the specific type of antacid your doctor recommends.

Taking this medicine will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Didanosine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Early symptoms of lactic acidosis may get worse over time and this condition can be fatal. Get emergency medical help if you have even mild symptoms: muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, fast or uneven heart rate, dizziness, or feeling very weak or tired.

Call your doctor at once if you have:

  • severe pain in your upper stomach (may spread to your back), swelling around your stomach, nausea, vomiting, loss of appetite;

  • fever, itching, tiredness, fast heart rate;

  • numbness, tingling, or pain in your hands or feet;

  • jaundice (yellowing of the skin or eyes); or

  • dark urine, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Didanosine may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works. Symptoms may occur weeks or months after you start treatment with didanosine. Tell your doctor if you have:

  • signs of a new infection--fever, night sweats, swollen glands, mouth sores, diarrhea, stomach pain, weight loss;

  • chest pain (especially when you breathe), dry cough, wheezing, feeling short of breath;

  • cold sores, sores on your genital or anal area;

  • rapid heart rate, feeling anxious or irritable, weakness or prickly feeling, problems with balance or eye movement;

  • trouble speaking or swallowing, severe lower back pain, loss of bladder or bowel control; or

  • swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence, loss of interest in sex.

Common side effects may include:

  • numbness or tingling;

  • vision changes;

  • nausea, vomiting, diarrhea, stomach pain;

  • rash;

  • headache; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Didanosine dosing information

Usual Adult Dose for HIV Infection:

Delayed-release capsules:
Less than 60 kg: 250 mg orally once a day
60 kg or more: 400 mg orally once a day

Oral solution:
Preferred dosing:
Less than 60 kg: 125 mg orally twice a day
60 kg or more: 200 mg orally twice a day

For patients requiring once-daily dosing:
Less than 60 kg: 250 mg orally once a day
60 kg or more: 400 mg orally once a day

Usual Adult Dose for Nonoccupational Exposure:

(Not approved by FDA)

Centers for Disease Control and Prevention recommendations:
Delayed-release capsules:
Less than 60 kg: 250 mg orally once a day
60 kg or more: 400 mg orally once a day

Oral solution:
Preferred dosing:
Less than 60 kg: 125 mg orally twice a day
60 kg or more: 200 mg orally twice a day

For patients requiring once-daily dosing:
Less than 60 kg: 250 mg orally once a day
60 kg or more: 400 mg orally once a day

Duration: 28 days

Prophylaxis should be initiated as soon as possible, within 72 hours of exposure. In general, the alternative regimens recommended for nonoccupational postexposure HIV prophylaxis include didanosine as part of protease inhibitor (PI)-based regimens.

Usual Pediatric Dose for HIV Infection:

Delayed-release capsules:
20 to less than 25 kg: 200 mg orally once a day
25 to less than 60 kg: 250 mg orally once a day
60 kg or more: 400 mg orally once a day

Oral solution:
2 weeks to 8 months: 100 mg/m2 orally twice a day
9 months to 18 years: 120 mg/m2 orally twice a day; adult dose should not be exceeded

What other drugs will affect didanosine?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • ganciclovir;

  • hydroxyurea;

  • methadone;

  • tetracycline;

  • tenofovir; or

  • medicines that should not be taken at the same time as didanosine--ciprofloxacin, delavirdine, indinavir, itraconazole, ketoconazole, or nelfinavir.

This list is not complete. Other drugs may interact with didanosine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about didanosine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.01.

Date modified: January 10, 2017
Last reviewed: September 29, 2016

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