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All about: Didanosine

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Generic name: Didanosine
Brand names: Videx

Why is Didanosine prescribed?

Videx is one of the drugs used to fight the human immunodeficiency virus (HIV)--the deadly cause of AIDS. Over a period of years, HIV slowly destroys the immune system, leaving the body defenseless against infection. Videx disrupts reproduction of HIV, thereby staving off the immune system's collapse.

Signs and symptoms of advanced HIV infection include diarrhea, fever, headache, infections, problems with the nervous system, rash, sore throat, and significant weight loss.

Most important fact about Didanosine

Although Videx can slow the progress of HIV, it is not a cure. You may continue to develop complications, including frequent infections. Even if you feel better, regular physical exams and blood counts by your doctor are highly advisable. And notify your doctor immediately if you experience any changes in your general health.

How should you take Didanosine?

Videx tablets and oral solution should be taken every 12 hours, exactly as prescribed. It is important to keep levels of the drug in your body as constant as possible, so be sure to take every scheduled dose. Videx should be taken on an empty stomach, at least 30 minutes before or 2 hours after a meal. Never take more than the prescribed dose; nerve disorders could result.

Videx Tablets

There should be at least 2 tablets in each dose, but to avoid stomach upset, do not take more than 4 tablets per dose. Do NOT swallow the tablets whole. Instead, take them in one of these three ways:

1. Chew the tablets thoroughly before swallowing.
2. Crush the tablets before you take them.
3. Dissolve the tablets in at least 1 ounce of water, stirring until the particles are evenly dispersed. Swallow the mixture immediately. If desired, you can add 1 ounce of apple juice to the water/Videx mixture. This combination should be taken within 1 hour of preparation. Be sure to stir it immediately before drinking.

Buffered Powder for Oral Solution

Open the packet and pour the contents into 4 ounces of water. Stir for 2 to 3 minutes, until the powder is completely dissolved. Drink the entire solution immediately. Do not mix with fruit juice.

Videx Pediatric Oral Solution

The pediatric version of Videx comes premixed from the pharmacy. Shake well before using.

Videx EC Delayed Release Capsules

This form is prescribed only when twice-daily dosing is impractical. Take 1 capsule daily on an empty stomach. Do not open the capsule. Swallow it whole.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Videx tablets and powder can be stored at room temperature. The pediatric oral solution should be stored in a refrigerator and used within 30 days.

What side effects may occur?

The higher your dosage, the greater your chance of side effects. However, it's often hard to tell a side effect from a symptom of the disease. If you think the drug is causing problems, keep taking it until you've checked with your doctor. Only your doctor can determine whether the drug is at fault and adjust your dosage accordingly.

  • More common side effects may include:
    Abdominal pain, chills, diarrhea, fever, headache, itching, nausea, pain, rash, tingling, burning, numbness, or pain in the feet and hands, vomiting, weakness

Why should Didanosine not be prescribed?

If Videx gives you an allergic reaction, you should not take the drug.

Special warnings about Didanosine

It's important to remember that Videx will not prevent the spread of HIV through sexual relations or contact with infected blood.

Videx can cause several serious side effects. Severe and even fatal pancreatitis (inflammation of the pancreas) is one possibility, especially if you've had the problem in the past, suffer from kidney disease, or drink alcoholic beverages. Combining Videx with Zerit increases the risk. Check with your doctor immediately if you develop such signs of pancreatitis as stomach pain, nausea, or vomiting; you may have to stop treatment with Videx. If you have any of the risk factors for pancreatitis, make sure the doctor is aware of it.

Videx has also been known to cause serious and even fatal liver damage. Signs of a liver problem include weakness, fatigue, stomach discomfort, dizziness, a cold feeling, and a sudden change in heartbeat. If you develop these symptoms, stop taking Videx and call your doctor immediately. Also be sure to tell the doctor if you've ever had a liver problem or tend to abuse alcohol; the doctor will watch you especially closely.

Videx can also effect the nervous system, causing changes in your eyesight or a feeling of tingling, numbness, or pain in your hands or feet (known as peripheral neuropathy). Alert your doctor immediately if you develop any of these problems. The doctor may need to change the dosage or stop the drug.

Some people receiving drugs for HIV experience a redistribution of body fat, leading to extra fat around the middle, a "buffalo hump" on the back, and wasting in the arms, legs, and face. Researchers don't know whether this represents a long-term health problem or not.

If you are on a sodium-restricted diet, you should be aware that Videx powder contains 1,380 milligrams of sodium per packet. Those with the hereditary disease phenylketonuria should remember that Videx tablets contain phenylalanine.

Possible food and drug interactions when taking Didanosine

Alcohol increases your risk of developing serious side effects such as pancreatitis.

Severe or even fatal reactions may occur if Videx is combined with tenofovir (Viread) or ribavirin (Rebetol, Virazol). If you need to take Videx while you're using either of these medications, your doctor will monitor you closely. If any of the symptoms for pancreatitis, lactic acidosis, or peripheral neuropathy occur (see "Special warnings about Didanosine"), contact the doctor immediately.

If Videx is taken with certain other medications, the effect of either may be increased, decreased, or altered. It is especially important to check with your doctor before taking any of the following:

Antacids containing magnesium or aluminum, including Maalox and Mylanta
Ganciclovir (Cytovene)
IV pentamidine (Pentam)
Methadone (Dolophine)
Stavudine (Zerit)
Tetracycline

It's best to avoid combining Videx with the gout medication Zyloprim. If you are taking Nizoral or Sporanox, you should allow at least 2 hours to pass before taking Videx. If you've been prescribed the HIV drugs Crixivan or Rescriptor, allow 1 hour to pass before taking Videx. When taking antibiotics known as quinolones, including Cipro, Floxin, and Noroxin, you should take Videx at least 6 hours before the antibiotic, or wait for 2 hours after it. If you've been prescribed the HIV drug Viracept, take it with a light meal 1 hour after Videx.

Special information if you are pregnant or breastfeeding

The effects of Videx during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately.

Combining Videx with the HIV drug Zerit seems to increase the danger of serious and even fatal liver reactions during pregnancy. Use this combination with special caution if you're pregnant.

HIV can be passed to a baby through breast milk, so you should not plan on breastfeeding.

Recommended dosage

If you have a kidney or liver problem, your dosage may be reduced.

ADULTS

Tablets

For adults weighing 132 pounds or more, the recommended dose is 200 milligrams every 12 hours. Those weighing less than 132 pounds usually take 125 milligrams every 12 hours.

Buffered Powder for Oral Solution

For adults weighing 132 pounds or more, the recommended dose is 250 milligrams every 12 hours. Those weighing less than 132 pounds usually take 167 milligrams every 12 hours.

Videx EC Delayed-Release Capsules

For adults weighing 132 pounds or more, the recommended dose is 400 milligrams once a day. If you weigh less than 132 pounds, the usual dose is 250 milligrams once a day.

CHILDREN

The recommended dose for pediatric patients 2 weeks of age and older varies according to the child's weight. Videx EC capsules are not prescribed for children.

Overdosage

  • Symptoms of Videx overdose may include:
    Abdominal pain, diarrhea, pain, numbness, burning, and tingling in the hands and feet

If you suspect an overdose, seek medical attention immediately.

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