POZ IRELAND
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POZ IRELAND
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DIDANOSINE (ddI) Videx® Approved for use in HIV infection in combination with other antiviral drugs. DESCRIPTION: ddI is a nucleoside analogue. DOSE: Adults / adolescents: 400 mg (> 60 Kg) or 300 mg (< 60 Kg) once a day. 200 mg (> 60 Kg) or 125 mg (< 60 Kg) twice a day. Tablets are dissolved in a small amount of water. ddI tablets should be taken at least a half hour before eating or two–four hours after eating. Videx EC: are enteric coated capsules of ddI. Due to the lack of antacid these capsules may cause less stomach upsets and related GI problems. Videx EC must be taken on an empty stomach at least two hours after eating. Paediatric: 120 mg/m2 BID. Neonates: 120 mg/m2 BID. Videx EC is recommended for use in children. SIDE EFFECTS: Pancreatitis, peripheral neuropathy, lactic acidosis and possibly liver failure are the most serious side effects. ddI, STAVUDINE AND HYDROXYUREA SHOULD BE SUSPENDED IN PEOPLE WITH SUSPECTED PANCREATITIS. DIDANOSINE SHOULD BE PERMANENTLY DISCONTINUED IN PEOPLE WITH CONFIRMED PANCREATITIS. The single greatest risk factor for developing pancreatitis is a prior history of pancreatitis. Other risk factors include ongoing alcohol abuse, severe obesity, hypertriglyceridaemia, cholelithiasis, other medications known to cause pancreatitis (e.g., pentamidine), medications known or thought to increase exposure to ddI (e.g. hydroxyurea, allopurinol), abnormal liver function tests and abnormal kidney function. Enlarged fatty liver and lactic acidosis have been reported in patients taking nucleoside analogues. Retinal changes and optic neuritis have also been reported in adults and children receiving ddI. PAEDIATRIC SIDE EFFECTS: Retinal lesions have been observed in children receiving ddI. Therefore all children receiving ddI should have retinal examinations every four to six months. RESISTANCE: There is considerable cross resistance among the nucleoside analogues. HIV that is resistant to ddI is also resistant to ddC. There is some evidence that HIV strains that have become resistant to AZT may regain sensitivity to AZT after treatment with ddI. INTERACTIONS: Dapsone/indinavir/delavirdine/ketoconazole: The buffer in ddI tablets may inhibit the absorption of these drugs. Indinavir and ddI should be taken one hour apart, both on an empty stomach; delavirdine should be taken an hour before or after taking ddI. Dapsone and ketoconazole should be taken two hours before ddI. With Tenofovir - If ddI is taken with tenofovir, levels of ddI can increase significantly. A dose reduction of ddI may be considered when a person is taking both ddI and tenofovir. Certainly close monitoring for side-effects is advised. Current clinical practice is to reduce the ddI dose to 250mg once daily. Oral Ganciclovir: May increase risk for pancreatitis, and levels of ddI are increased when taking oral ganciclovir. ddI should not be combined with IV Pentamidine. Methadone decreases the blood levels of ddI. ddI should not be combined with ddC. Pregnant women should not take ddI and d4T together due to the increased risk of lactic acidosis.
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