Didanosine (ddI) is one of the older NRTIs and, while not the preferred option, may be used in a first-line regimen in combination with lamivudine or emtricitabine and either a boosted PIA type of anti-HIV drug that works by preventing the production of an enzyme, protease, that HIV needs to replicate. or an NNRTI.
The original, large-dose, chalk tablet form that ddI used to take (which was difficult to take) has been replaced by capsules.
February 2010 Update
Labeling Revision - Risk of Non-Cirrhotic Portal HypertensionPersistently high blood pressure, an outwardly symptomless condition which carries an increased risk of serious illnesses such as stroke, heart disease and heart attack.
The FDAThe U.S. Department of Health and Human Services agency responsible for ensuring the safety and effectiveness of all drugs, biologics, vaccines, and medical devices, including those used in the diagnosis, treatment, and prevention of HIV infection, AIDS, and AIDS-related opportunistic infections. The FDA also works with the blood banking industry to safeguard the nation's blood supply. The Australian equivalent is the Therapeutic Goods Administration (TGA). has notified healthcare professionals and patients about a rare, but serious, complication in the liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. known as non-cirrhotic portal hypertension in patients using didanosine.
Read the complete MedWatch 2010 Safety summary including a link to the Drug Safety Communication, at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuma...
| Generic name: |
didanosine (ddI) |
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| Pronunciation: | dye-DAN-oh-seen |
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| Brand name: | Videx |
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| Also known as: | Videx EC (enteric coated)
2’,3’-dideoxyinosine
Generic versions include Dinex EC, Viro-Z, Aviro-Z and Divir. |
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| Drug class: | nucleoside analogue |
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| Pregnancy safe? | Not suitable for use in pregnancy. If you are pregnant or may become pregnant, you should not take this treatment. |
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| Pediatric dosing? | Available in doses suitable for children and/or young people. |
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| Availability in Australia: | - Available on the Pharmaceutical Benefits Scheme (PBS) through S100 prescribers.
- This drug may be available through clinical trials in Australia.
- You may be able to import this drug from overseas for your personal use.
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| Presentation: | 125mg capsule;200mg capsule;250mg capsule;400mg capsule |
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| What the treatment guidelines say: | Didanosine should not be used in combination with tenofovir or unboosted atazanavir.
Didanosine use also is associated with an increased risk for pancreatitis, peripheral neuropathy, and possibly other mitochondria-associated toxicities. |
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| Links: | |
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Like all anti-HIV drugs, didanosine must be taken in combination with other drugs to be completely effective.
Commonly, didanosine is combined with one other nucleoside (NRTI) drug and either a protease inhibitor or non-nucleoside, although other combinations are sometimes used. Your doctor will advise you on the right combination of drugs to suit your circumstances.
Dosage
The dose for people over 60kg is one 400mg capsule once a day. For people under 60kg the dose is 250mg once a day. ddI is considered to be safe for use in children over two weeks of old and is available a a buffered powder, but can cause a rare side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. in children that damages the eyes.
ddI should be used with caution during pregancy.
In the two hours before and after taking ddI, do not eat and drink nothing but water.
Regardless of what you read on this website or elsewhere, you should always take your medications according to your doctor's instructions. If you're unsure, speak to your doctor or pharmacist.
With or without food?
Didanosine must be taken on an empty stomach.
Side effects
All drugs can produce side effects in some people. These may be mild, moderate or severe, so you should be aware of potential side effects before starting any drug, and speak to your doctor if you experience side effects that concern you.
- Common side effects may include diarrhoea, peripheral neuropathy, insomnia.
- Less common side effects may include nausea (upset stomach, feeling sick to the stomach), vomiting, headache, rash, fever, chills, pain, dry mouth.
- Rare side effects may include lipodystrophy, pancreatitis, lactic acidosis, liver damage.
It's unlikely you will experience all of these side effects, and you may not experience any side effects at all. Before starting any new drug, ask your doctor about side effects you might experience and discuss strategies for dealing with side effects if they do occur. If you experience any significant side effect you should continue taking your medicine and see your doctor as soon as possible.
Interactions with other drugs
Many other medications can reduce the amount of ddI that the body absorbs. Indinavir and ritonavir should not be taken within two hours of ddI.
Tenofovir (viread) can increase levels of ddI by up to 64%, which puts patients at high risk of side efefcts such as pancreatitis and neuropathy. This combination can also cause a drop in CD4 cells and has also been linked to resistance.
A number of drugs can increase the risk of ddI-related pancreatitis and should be avoided. These include d4T, demeckicycline, doxycycline, hydroxycarbamine, lymecycline, minocycline, oxytetracycline, pentamadine isetionate and tetracycline.
Alcohol can also increase the risk of pancreatitis.
Methadone may reduce the absorption of ddI.
Latest results presented by investigators at the CROI meeting in February in Boston suggested that treatment with abacavir (also found in the combination pills Kivexa and Trizivir) and ddI (didanosine, Videx) may significantly increase the risk of myocardial infarction, or heart attackA life-threatening emergency in which the blood supply to the heart is suddenly cut off, causing the heart muscle (myocardium) to die from lack of oxygen.. read more »
Nucleoside analoguesA type of anti-HIV drug that works by inhibiting a stage of the HIV life cycle called reverse transcription. Non-nucleosides work in a similar way, but are chemically different. are the backbone of successful anti-HIV treatments. This article examines some of the issues involved in selecting the best nucleoside backbone. read more »
Positive Living article • Jim Arachne • 19 December 2004
Peripheral neuropathy (PN) is a debilitating treatment side effectAn unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time. and one of the common reasons for people stopping their anti-HIV medication. read more »
Pancreatitis is in the news. With opposition leader Mark Latham struck down by this painful condition, we look at the role of the pancreas and at HIV-related pancreatitis. read more »
We all want simpler treatment regimens with fewer side effects and no meal restrictions, right? Well how does once-a-day treatment sound? As PAUL KIDD reports, it may be closer than you think. read more »
Positive Living article • Sean Slavin • 1 February 2003
Representations of positive people in the media. By Sean Slavin. read more »
The table below shows all the clinical trials in the database with the keyword didanosine (ddI).
Sorry, no clinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. trials database entries were found that matched your request.
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