What is Videx EC (Didanosine)?
Videx EC (Didanosine) is a NRTI (Nucleoside Reverse Transcriptase Inhibitor) drug that is used in combination with other antiretroviral medications for the treatment of HIV.
Dosing & Administration
Videx EC is used to treat HIV in adults, children, and infants. Although it is approved to use with infants, it should be used with caution for incants who are younger than three months old. The drug comes as either an oral liquid or an extended-release “gastro-resistant” capsule, which cannot be crushed, chewed, or opened. Dosing is further detailed in the package insert. Although it is recommended to be taken on an empty stomach, research has suggested that it may be taken with or without food.
As outlined in the package insert, adjustments in dosing are required for patients with any degree of renal dysfunction. This drug should be used with extreme caution for patients with either risk factors for liver disease or liver dysfunction.
Videx EC is contraindicated for patients who are taking stavudine or who have hypersensitivity to the drug. Further details are provided in the accompanying package insert.
Videx EC has been associated with optic nerve lesions, pancreatitis, non-cirrhotic portal hypertension, osteonecrosis, hepatotoxicity, peripheral neuropathy, immune reactivation syndrome, and lipoatrophy. Additional details are provided in the package insert.
Videx EC has a possible association with lactic acidosis or hepatotoxicity. Some risk factors include being female, obesity, and prolonged therapy. Patients should also be cautious if they take medication that has an association with pancreatitis or for those with a history of pancreatitis. This medication has been associated with hepatomegaly with steatosis and lactic acidosis with a high mortality rate. Details about the recommendations for screening and monitoring are included in the package insert.
The underlying risk for myocardial infarction is increased, so this needs to be considered before Videx EC is prescribed.
HIV-infected patients should also be screened for a comorbid Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection. Those patients who are co-infected should be started on an antiretroviral regimen that will target co-infected viruses, regardless of CD4 counts or viral loads. Treatment guidelines outline further details about prescribing and drug schedules.
Videx EC is associated with drug to drug and herbal interactions and contraindications. Details about possible interactions are described further in the package insert.
Pregnancy & Lactation
Current guidelines should be investigated when treating women who are pregnant. Videx EC is teratogenic. The CDC recommends that all women who are breastfeeding and are HIV positive, avoid breastfeeding to prevent transmission of the virus.
Since there is no known antidote for an overdose of Videx EC, close monitoring and standard supportive treatment should be used in the case of an overdose. Didanosine is partially dialyzed.
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