Didanosine

When ATH:
J05AF02

Characteristic.

The white crystalline powder. Soluble in water (at 25 ° C and pH 6 solubility is 27,3 mg / ml). Unstable in acidic medium (at a pH of less 3 and temperature 37 °C 10% the drug breaks down to less than hypoxanthine, than 2 m).

Pharmacological action.
Antiviral, inhibiting HIV reverse transcriptase.

Application.

HIV-infection in adults, long-term AZT, intolerance to zidovudine or symptoms of clinical and immunological failure on the background of his appointment in adults and children (senior 8 Months).

Contraindications.

Hypersensitivity, resistance, alcoholism, hypertriglyceridemia, pancreatitis, incl. history (may develop acute pancreatitis, sometimes with fatal consequences), gout (increases the concentration of uric acid in the blood), states, require restricting the sodium in the body: heart failure, cirrhosis or severe liver dysfunction, peripheral edema and / or congestion in the pulmonary circulation, gipernatriemiya, hypertension, renal failure, toxemia of pregnancy, phenylketonuria (Chewable dispersible tablets and contain 45 to 67,4 mg phenylalanine).

Restrictions apply.

Violation of the liver and kidneys (Cl creatinine less than 60 ml / min), tk. cumulative effect is possible and the development of toxic effects, peripheral neuropathy.

Pregnancy and breast-feeding.

Contraindicated in pregnancy toxemia.

Side effects.

Dyspepsia (epigastric pain, nausea, diarrhea), acute pancreatitis (abdominal pain, nausea, anacatharsis), hepatitis (pain in the right upper quadrant, Yellow staining of the skin and sclera), peripheral neuropathy (pricking, burning, pain and numbness in the lower extremities), alarm, headache, irritability, insomnia, seizures, depigmentation of the retina (only children), anemia, granulocytopenia, leukopenia, thrombocytopenia (increased bleeding, Hemorrhagic rash), allergic reactions (fever and sweating, skin rash and itching).

Cooperation.

Alcohol, asparaginase, azathioprine, valproic acid and its derivatives, metildofa, sulfonamides derivatives, thiazide diuretics and furosemide, tetracikliny, Estrogens and other drugs pankreotoksichnye increase the risk of pancreatitis, chloramphenicol (levomicetin), ethambutol, ethionamide, gidralazin, Isoniazid, lithium salt, metronidazol, phenytoin, Vincristine-peripheral neuropathy. As a result of raising the pH reduces the absorption of substances, which is needed for the absorption of acidic environment (dapsone, ketoconazole, itraconazole, and others.). Magnesium and aluminum salts buffer system drugs didanosine chelate compound with fluoroquinolones, Tetracycline, which drastically reduces their absorption.

Overdose.

Symptoms: pancreatitis, peripheral neuropathy, diarrhea, hyperuricemia, liver dysfunction.

Treatment: symptomatic (there is no specific antidote). Hemodialysis gives little effect (for 4 h concentration in blood serum reduction applies only to 20%).

Dosing and Administration.

Inside, fasting. Every adult 12 no: body weight up 60 kg - 167 mg powder or 125 mg per Tablet, 60-74 kg 250 mg powder or 200 mg tablets, above 75 kg - 375 mg powder or 300 mg tablets.

Babies (senior 8 Months): dose counting physician body surface area, is usually 25-100 mg every 8-12 hours.

Patients anuriei (dialysis) used 1/4 total daily dose 1 once a day.

Precautions.

Ftorkhinolony, tetracikliny, dapsone, ketoconazole, itraconazole appointed for 2 hours before or after 2 hours after didanosine.