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Didanosine

 Herbs
 Interactions with Supplements
 Interactions with Herbs
 Other Interactions
 References


Alternative Medicine
The following information is specific for alternative and complementary medicine. For additional evidence-based information on diseases, conditions, symptoms, diagnosis, treatment and wellness issues, continue searching the Healthwise Knowledgebase.


Also indexed as:

DDL (ddl), Dideoxyinosine, Videx



Didanosine is a drug that blocks reproduction of the human immunodeficiency virus (HIV). HIV is the virus that infects people causing acquired immunodeficiency syndrome (AIDS). Didanosine is used in combination with other drugs to treat HIV infection.

Herbs

Summary of Interactions for Didanosine

Depletion or interference Acetyl-L-carnitine
Adverse interactionNone known
Side effect reduction/prevention Acetyl-L-carnitine
Riboflavin
Supportive interaction Shiitake*
Reduced drug absorption/bioavailabilityNone known


An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Riboflavin

Persons with AIDS have developed lactic acidosis and fatty liver while taking didanosine and other drugs in its class. Didanosine can inhibit crucial DNA-related riboflavin activity, which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory tests returned to normal and her lactic acidosis was completely resolved.1 More research is needed to confirm the value of riboflavin for preventing and treating this side effect.

Acetyl-L-carnitine

Severe peripheral neuropathy (painful sensations due to nerve damage in the hands and feet) often develops in people taking didanosine or other drugs in its class. People with peripheral neuropathy who were taking one of these drugs were found to be deficient in acetyl-L-carnitine.2 In a preliminary trial, supplementation with 1,500 mg of acetyl-L-carnitine twice a day resulted in improvement in the neuropathy after six months in people taking didanosine or related drugs.3 Similar benefits were seen in another study that used the same amount of acetyl-L-carnitine.4

Interactions with Herbs

Shiitake (Lentinas edodes)

Lentinan is a complex sugar found in shiitake mushrooms and is recognized as an immune modulator. In an early human trial, 88 HIV-infected people received didanosine (400 mg per day) plus a 2 mg lentinan injection per week.5 Didanosine-lentinan combination therapy improved CD4 immune cell counts for a significantly longer period than didanosine alone. Lentinan is under investigation as an adjunct therapy to be used with didanosine for HIV infection.6 Oral preparations of shiitake are available, but it is not known if they would be an effective treatment with didanosine for HIV infection.

Other Interactions

Food

Didanosine should be taken on an empty stomach, one hour before or two hours after eating food.7

References

  1. Fouty B, Frerman F, Reves R. Riboflavin to treat nucleoside analogue-induced lactic acidosis. Lancet 1998;352:291-2 [letter].
  2. Famularo G, Moretti S, Marcellini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 1997;11:185-90.
  3. Hart AM, Wilson AD, Montovani C, et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS 2004;18:1549-60.
  4. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV Clin Trials 2005;6:344-50.
  5. Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200-500/mm3. J Med 1995;26:193-207.
  6. Threlkeld DS, ed. News, Keeping Up, December 1994, Lentinan. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Dec 1997, 805.
  7. Threlkeld DS, ed. Anti-Infectives, Antiviral Agents, Didanosine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 406k-6t.

Last Review: 09-07-2006

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires August 2007.



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