VIDEX EC (didanosine) is a Nucleoside Reverse Transcriptase Inhibitor (NRTI) drug used for the treatment of HIV in combination with other antiretroviral medications.
Dosing & Administration
VIDEX EC is indicated for the treatment of HIV infection in adults, children, and neonates. Despite its approval for use, it should be used with caution in infants under three months at its recommended dosage. VIDEX EC comes in an extended-release “gastro-resistant” capsule, which cannot be crushed, chewed, or opened, and also comes in an oral liquid formulation. The manufacturer recommends taking the medication on an empty stomach, but post-marketing studies suggest that it may be taken with or without food. Dosing is detailed in the product monograph.
Dosing adjustments are required for any degree of renal dysfunction, as outlined in the product monograph. Safety and efficacy for patients with underlying liver disease has not been established, and the drug should be used with extreme caution in those with liver dysfunction or risk factors for liver disease.
VIDEX EC is contraindicated in patients with hypersensitivity to the drug, and in patients taking stavudine. Details are given in the product monograph.
VIDEX EC has been associated with pancreatitis, hepatotoxicity, non-cirrhotic portal hypertension, peripheral neuropathy, optic nerve lesions, immune reactivation syndrome, lipoatrophy, and osteonecrosis. A complete list of potential adverse effects is provided in the product monograph.
VIDEX EC has a boxed warning of its association with hepatotoxicity or lactic acidosis. Female gender, obesity, and prolonged therapy are risk factors. VIDEX EC also has a boxed warning advising extreme caution if used in patients with a history of pancreatitis or who take other medications with a known association with pancreatitis. VIDEX EC has been associated with lactic acidosis and hepatomegaly with steatosis with a high mortality rate. Screening and monitoring recommendations for all these concerns are detailed in the product monograph.
VIDEX EC may be associated with an increased risk of myocardial infarction, so the underlying risk of individual patients should be considered prior to prescribing.
All patients who test positive for an HIV infection should be screened for a comorbid Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection. Co-infected patients should be started on an antiretroviral regimen targeting co-infected viruses, regardless of CD4 counts or viral loads. Current HIV treatment guidelines outline drug regimens and prescribing considerations.
VIDEX EC is associated with a large number of drug-drug and herbal interactions and contraindications. These are listed in the product monograph.
Pregnancy & Lactation
VIDEX EC is teratogenic. Current guidelines should be consulted when treating pregnant women. It is unknown if VIDEX EC is excreted in breast milk. The CDC recommends that all HIV positive women, treated or untreated, avoid breastfeeding to prevent vertical transmission of the virus.
There is no known antidote for VIDEX EC overdose, so standard supportive treatment and close monitoring should be used. Didanosine is partially dialyzed.
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