WARNING

Didanosine, often abbreviated as DDI, is an antiretroviral medication used in the treatment of HIV/AIDS. While effective in managing the virus, like any medication, it carries certain risks. Some potential risks of taking DDI include:

• Pancreatitis: DDI has been associated with inflammation of the pancreas, known as pancreatitis. This can cause severe abdominal pain, nausea, and vomiting.
• Liver problems: DDI may cause liver toxicity, leading to elevated liver enzymes or even liver failure in some cases.
• Peripheral neuropathy: Some individuals may experience nerve damage, leading to symptoms such as tingling, numbness, or pain in the hands and feet.
• Immune reconstitution syndrome: When starting antiretroviral therapy, including DDI, some HIV patients may experience an inflammatory response as the immune system improves, leading to symptoms similar to an infection or worsening of pre-existing conditions.
• Lactic acidosis: DDI has been associated with an increased risk of lactic acidosis, a serious condition characterized by the buildup of lactate in the blood, leading to symptoms such as weakness, rapid breathing, nausea, and abdominal pain.

It’s essential for individuals taking DDI to be monitored closely by their healthcare provider for any signs of these potential side effects, and to report any concerning symptoms promptly.

Why is this medication prescribed?

Didanosine (DDI) is prescribed primarily for the treatment of HIV infection. It belongs to a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs), which work by inhibiting the replication of the HIV virus, slowing down its progression in the body, and improving the immune system function.

How should this medicine be used?

Here’s how DDI is typically used:

• Prescription: DDI is available in various forms, including tablets, capsules, and powder for oral solution. The specific form and dosage prescribed will depend on individual factors such as the patient’s age, weight, other medications being taken, and the severity of the HIV infection.
• Dosage: The usual dosage of DDI can vary but is often taken once or twice daily. It’s crucial to follow the prescribed dosage and schedule provided by the healthcare provider.
• Administration: DDI should be taken on an empty stomach, at least 30 minutes before or 2 hours after a meal, to ensure optimal absorption. The tablets or capsules should be swallowed whole with water, without chewing or crushing.
• Adherence: It’s essential for individuals prescribed DDI to take the medication exactly as directed, without missing doses. Consistent adherence to the prescribed regimen is critical for the effectiveness of HIV treatment and to prevent the development of drug resistance.
• Monitoring: Patients taking DDI should be regularly monitored by their healthcare provider for any signs of side effects or complications. This may include routine blood tests to assess liver function, kidney function, and other relevant parameters.
• Combination therapy: DDI is often used as part of combination therapy, where it’s taken in conjunction with other antiretroviral medications to maximize effectiveness and reduce the risk of developing drug resistance.
• Precautions: Individuals prescribed DDI should avoid consuming alcohol and certain other medications that may interact negatively with DDI. It’s essential to discuss all current medications and medical conditions with the healthcare provider before starting DDI therapy.

Always consult your healthcare provider or pharmacist if you have any questions or concerns about how to properly use DDI.

Other uses for this medicine

• Chronic Hepatitis B: DDI has been investigated as a treatment for chronic hepatitis B virus (HBV) infection, particularly in patients co-infected with HIV and HBV.
• Experimental Cancer Treatment: DDI has shown some promise in preclinical studies as a potential treatment for certain types of cancer, such as lymphoma and leukemia. However, further research is needed to determine its efficacy and safety in cancer treatment.
• Investigational Therapies: DDI may be used in clinical trials or investigational settings for the treatment of other viral infections or medical conditions. However, these uses are not yet established as standard practice.

What special precautions should I follow?

Regarding special precautions for DDI, it’s important to follow these guidelines:

• Medical History: Before starting DDI therapy, inform your healthcare provider about any medical conditions you have, especially liver or kidney disease, pancreatitis, peripheral neuropathy, or a history of alcohol abuse.
• Medication Interactions: DDI can interact with other medications, including certain antacids, antibiotics, antiviral drugs, and drugs that affect stomach acid levels. Inform your healthcare provider about all medications, supplements, and herbal products you are taking before starting DDI.
• Alcohol and Recreational Drugs: Avoid consuming alcohol or recreational drugs that may cause liver damage while taking DDI, as it can increase the risk of liver toxicity.
• Pregnancy and Breastfeeding: DDI should be used with caution during pregnancy, especially in the first trimester, and only if the potential benefits outweigh the risks. It’s important to discuss the risks and benefits with your healthcare provider if you are pregnant or planning to become pregnant while taking DDI. DDI may also pass into breast milk, so breastfeeding while taking DDI is not recommended unless specifically advised by a healthcare provider.
• Monitoring: Regular monitoring of liver function, kidney function, and blood cell counts may be necessary while taking DDI to detect and manage any potential side effects or complications.
• Adherence: Take DDI exactly as prescribed by your healthcare provider, without skipping doses or changing the dosage without consulting them first.
• Symptom Recognition: Be aware of potential side effects of DDI, such as abdominal pain, nausea, vomiting, jaundice, tingling or numbness in the hands or feet, and report any unusual symptoms to your healthcare provider promptly.

By following these precautions and guidelines, you can help minimize the risks associated with taking DDI and maximize its effectiveness in managing your condition.

What special dietary instructions should I follow?

• Empty Stomach: DDI should be taken on an empty stomach, at least 30 minutes before or 2 hours after a meal, to ensure optimal absorption.
• Avoid Dairy Products: Some formulations of DDI may contain lactose, so if you are lactose intolerant, check with your healthcare provider or pharmacist about suitable alternatives.
• Hydration: Maintain adequate hydration while taking DDI, as dehydration can increase the risk of kidney problems.

What should I do if I forget a dose?

If you miss a dose of DDI, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Didanosine (DDI) can cause a range of side effects, some of which can be serious. It’s important to be aware of these potential side effects and to report any concerning symptoms to your healthcare provider promptly. Common side effects of DDI may include:

• Nausea and vomiting: These gastrointestinal symptoms are among the most common side effects of DDI.
• Diarrhea: Some individuals may experience diarrhea while taking DDI.
• Abdominal pain: DDI can cause abdominal discomfort or pain in some people.
• Headache: Headaches are a relatively common side effect of DDI.
• Fatigue: Some individuals may experience fatigue or weakness while taking DDI.
• Peripheral neuropathy: DDI can cause nerve damage, leading to symptoms such as tingling, numbness, or pain in the hands and feet.
• Pancreatitis: Inflammation of the pancreas, known as pancreatitis, is a potential side effect of DDI. This can cause severe abdominal pain, nausea, and vomiting.
• Liver problems: DDI may cause liver toxicity, leading to elevated liver enzymes or even liver failure in some cases.
• Lactic acidosis: DDI has been associated with an increased risk of lactic acidosis, a serious condition characterized by the buildup of lactate in the blood, leading to symptoms such as weakness, rapid breathing, nausea, and abdominal pain.
• Immune reconstitution syndrome: When starting antiretroviral therapy, including DDI, some HIV patients may experience an inflammatory response as the immune system improves, leading to symptoms similar to an infection or worsening of pre-existing conditions.

It’s important to note that this is not an exhaustive list of side effects, and individual experiences may vary. Additionally, some side effects of DDI can be serious and require immediate medical attention. If you experience any unusual or severe symptoms while taking DDI, contact your healthcare provider or seek medical attention promptly.

What should I know about storage and disposal of this medication?

Regarding the storage and disposal of DDI:

Storage of DDI:

• Room Temperature: Store DDI at room temperature away from light and moisture. Avoid storing it in the bathroom, where it might be exposed to moisture.
• Keep Out of Reach of Children: Store DDI in a location where children and pets cannot access it, as it can be harmful if ingested accidentally.
• Do Not Freeze: Do not freeze DDI, as freezing may affect its effectiveness.
• Follow Specific Instructions: Follow any specific storage instructions provided by your pharmacist or healthcare provider, as different formulations of DDI may have specific storage requirements.

Disposal of DDI:

• Dispose Properly: Dispose of any unused or expired DDI properly according to local guidelines or regulations. Do not flush medications down the toilet or pour them down the drain unless instructed to do so.
• Take-Back Programs: Check if there are any medication take-back programs in your area where you can safely dispose of unused medications.
• Mix with Unpalatable Substance: If there are no take-back programs available, mix the unused medication with an unpalatable substance (e.g., dirt, cat litter) in a sealed plastic bag before throwing it away in the trash.

In case of emergency/overdose

• Seek Medical Attention: In case of an overdose or emergency, such as accidentally taking too much DDI, seek immediate medical attention or contact your local poison control center.
• Symptom Management: If someone has overdosed on DDI, the treatment will likely involve managing symptoms and providing supportive care. The specific treatment will depend on the severity of the overdose and the symptoms presented.

What other information should I know?

• Regular Monitoring: Your healthcare provider may recommend regular monitoring of your condition, including blood tests to check liver function, kidney function, and other relevant parameters while taking DDI.
• Follow-up Appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your response to DDI therapy and to address any concerns or side effects.
• Avoid Alcohol and Recreational Drugs: Avoid consuming alcohol or recreational drugs that may interact negatively with DDI, as it can increase the risk of side effects and toxicity.
• Inform Healthcare Providers: Inform all healthcare providers involved in your care, including dentists and specialists, that you are taking DDI, as it may interact with other medications or treatments.
• Adherence: Take DDI exactly as prescribed by your healthcare provider, and do not stop taking it without consulting them first, even if you feel better.

By following these guidelines and staying informed about DDI, you can help ensure its safe and effective use in managing your condition.