Standard Dose: One 400 mg enteric coated (Videx EC) delayed-release capsule once-a-day, with adjustments for weight and when combined with Viread or Truvada. (Also available in 125 mg, 200 mg and 250 mg caps.) Videx is also available as a buffered powder for oral solution. Take Videx and Videx EC strictly on an empty stomach (unless taking with Viread), one hour before or two hours after food or drink, except water. A reduced dose may be needed for people with kidney problems. Take missed dose as soon as possible, but do not double up on your next dose. Generic Videx EC is available.

AWP: $332.20 for Videx-EC (generic enteric-coated $311.41) / month

Manufacturer contact: Bristol-Myers Squibb,
www.bmsvirology.com, 1 (800) 272–4878

AIDSInfo:1 (800) HIV–0440 (448–0440), www.aidsinfo.nih.gov

Peripheral neuropathy (tingling, burning, numbness or pain in the hands or feet) may go away once didanosine is stopped, but can be painful and permanently debilitating if not treated in time and occurs more frequently when used with Zerit. Upset stomach, diarrhea, headache, and more rarely pancreatitis has also been reported. Other toxicities include eye changes and optic neuritis. Have periodic eye exam by someone who is aware you are HIV-positive. Increased uric acid levels (indicating a number of disorders, including kidney damage and metabolic diseases), and insomnia are other potential side effects. Rare but potentially fatal toxicity with all NRTIs is pancreatitis, enlarged, fatty liver, and lactic acidosis (accumulation of lactate in the blood and abnormal acid-base balance). Lactic acidosis has been seen in patients taking NRTIs but is more common and more severe in women, people who are obese and people who have been taking nukes for a long time; and more common in people with liver disease, but can occur in people without a history of liver damage. People with lactic acidosis may experience persistent fatigue, abdominal pain or distension, nausea/vomiting, and difficulty breathing or shortness of breath; and enlarged, fatty liver.

People with a history of peripheral neuropathy, pancreatitis or heavy alcohol use should avoid didanosine. Pancreatitis can be life-threatening and may cause pain in the stomach and back, along with nausea, vomiting and blood in the urine. Risks for pancreatitis include: higher than recommended doses of NRTIs, advanced HIV, and alcohol use. Body fat redistribution/accumulation has also been reported with didanosine.

Study indicates Videx EC (compared to Videx) may have lower risk of peripheral neuropathy. Either drug taken with Zerit increases the risk of facial wasting, pancreatitis, or lactic acidosis. Swallow the capsules whole. The capsules eliminate the bad taste and texture of the tablets and the enteric coating reduces diarrhea. Absorption can be decreased by as much as 50% when taken with food, so take on an empty stomach. Antacids containing magnesium or aluminum may cause adverse side effects if given at the same time as Videx tablets. If you have reduced kidney function, you may require a lower dose. Notify your doctor immediately if peripheral neuropathy is suspected.