HIV POSITIVE Treatment
ddI (Dideoxyinosine™)

Dideoxyinosine, ddI is a purine nucleoside analogue. Its trade name is Videx. Since ddI has different side effects than AZT, patients who are unable to tolerate AZT, may be able to substitute ddI. ddI is also proven effective in combination with AZT. Recent trials indicate that anti-HIV drugs are more effective when used in combination.

ddI is used in the treatment of the infection caused by the human immunodeficiency virus (HIV). HIV is the virus responsible for acquired immune deficiency syndrome (AIDS).

ddI (ddI) will not cure or prevent HIV infection or AIDS; however, it helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay the development of problems usually related to AIDS or HIV disease. ddI will not keep you from spreading HIV to other people. People who receive this medicine may continue to have the problems usually related to AIDS or HIV disease.

ddI may cause some serious side effects, including pancreatitis (inflammation of the pancreas). Symptoms of pancreatitis include stomach pain, and nausea and vomiting. ddI may also cause peripheral neuropathy. Symptoms of peripheral neuropathy include tingling, burning, numbness, and pain in the hands or feet. CHECK WITH YOUR DOCTOR IF ANY NEW HEALTH PROBLEMS OR SYMPTOMS OCCUR WHILE YOU ARE TAKING ddI.

ddI is available only with your doctor's prescription, in the following dosage forms:

Oral

  • Oral solution (U.S.)
  • Oral suspension (U.S. and Canada)
  • Tablets (U.S. and Canada)


Before Using ddI

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ddI, the following should be considered:

Allergies:
Tell your doctor if you have ever had any unusual or allergic reaction to ddI. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet:
Make certain your health care professional knows if you are on any special diet, such as a low-sodium (low-salt) diet. ddI chewable tablets and the oral solution packets contain a large amount of sodium. Also, ddI tablets contain phenylalanine, which must be restricted in patients with phenylketonuria.

Pregnancy:
ddI crosses the placenta. Studies in pregnant women have not been done. However, ddI has not been shown to cause birth defects or other problems in animal studies. Also, it is not known whether ddI reduces the chances that a baby born to an HIV-infected mother will also be infected.

Breast-feeding:
It is not known whether ddI passes into the breast milk. However, if your baby does not already have the AIDS virus, there is a chance that you could pass it to your baby by breast-feeding. Talk to your doctor first if you are thinking about breast-feeding your baby.

Children:
ddI can cause serious side effects in any patient. Therefore, it is especially important that you discuss with your child's doctor the good that this medicine may do as well as the risks of using it. Your child must be carefully followed, and frequently seen, by the doctor while taking ddI.

Older adults:
Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of ddI in the elderly with use in other age groups.

Other medicines:
Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ddI, it is especially important that your health care professional know if you are taking any of the following:

  • Alcohol or
  • Asparaginase (e.g., Elspar) or
  • Azathioprine (e.g., Imuran) or
  • Estrogens (female hormones) or
  • Furosemide (e.g., Lasix) or
  • Methyldopa (e.g., Aldomet) or
  • Pentamidine (e.g., Pentam, Pentacarinat) or
  • Sulfonamides (e.g., Bactrim, Septra) or
  • Sulindac (e.g., Clinoril) or
  • Thiazide diuretics (e.g., Diuril, Hydrodiuril) or
  • Valproic acid (e.g., Depakote) -- Use of these medicines with ddI may increase the chance of pancreatitis (inflammation of the pancreas)
  • Chloramphenicol (e.g., Chloromycetin) or
  • Cisplatin (e.g., Platinol) or
  • Ethambutol (e.g., Myambutol) or
  • Ethionamide (e.g., Trecator-SC) or
  • Hydralazine (e.g., Apresoline) or
  • Isoniazid (e.g., Nydrazid) or
  • Lithium (e.g., Eskalith, Lithobid) or
  • Metronidazole (e.g., Flagyl) or
  • Nitrous oxide or
  • Phenytoin (e.g., Dilantin) or
  • Stavudine (e.g., D4T) or
  • Vincristine (e.g., Oncovin) or
  • Zalcitabine (e.g., HIVID) -- Use of these medicines with ddI may increase the chance of peripheral neuropathy (tingling, burning, numbness, or pain in your hands or feet)
  • Ciprofloxacin (e.g., Cipro) or
  • Enoxacin (e.g., Penetrex) or
  • Itraconazole (e.g., Sporanox) or
  • Ketoconazole (e.g., Nizoral) or
  • Lomefloxacin (e.g., Maxaquin) or
  • Norfloxacin (e.g., Noroxin) or
  • Ofloxacin (e.g., Floxin) or
  • Trimethoprim (e.g., Proloprim, Trimpex) -- Use of these medicines with ddI may keep these medicines from working properly; these medicines should be taken at least 2 hours before or 2 hours after taking ddI
  • Dapsone (e.g., Avlosulfon) -- Use of dapsone with ddI may increase the chance of peripheral neuropathy (tingling, burning, numbness, or pain in your hands or feet); it may also keep dapsone from working properly; dapsone should be taken at least 2 hours before or 2 hours after taking ddI
  • Nitrofurantoin (e.g., Macrodantin) -- Use of nitrofurantoin with ddI may increase the chance of pancreatitis (inflammation of the pancreas) and peripheral neuropathy (tingling, burning, numbness, or pain in your hands or feet)
  • Tetracyclines (e.g., Achromycin, Minocin) -- Use of tetracyclines with ddI may increase the chance of pancreatitis (inflammation of the pancreas); it may also keep the tetracycline from working properly; tetracyclines should be taken at least 2 hours before or 2 hours after taking ddI

Other medical problems:
The presence of other medical problems may affect the use of ddI. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcoholism, active, or
  • Increased blood triglycerides (substance formed in the body from fats in foods) or
  • Pancreatitis (or a history of) -- Patients with these medical problems may be at increased risk of pancreatitis (inflammation of the pancreas)
  • Edema or
  • Heart disease or
  • High blood pressure or
  • Kidney disease or
  • Liver disease or
  • Toxemia of pregnancy -- The salt contained in the ddI tablets and the oral solution packets may make these conditions worse
  • Gouty arthritis -- ddI may cause an attack or worsen gout
  • Peripheral neuropathy -- ddI may make this condition worse
  • Phenylketonuria (PKU) -- ddI tablets contain phenylalanine, which must be restricted in patients with PKU


Proper Use of ddI

ddI should be taken exactly as your doctor directs without variation. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Also, do not stop taking this medicine without checking with your doctor first. However, stop taking ddI and call your doctor right away if you get severe nausea, vomiting, and stomach pain.

ddI must be taken for its full time of treatment, do not stop even if you begin to feel better.

For patients taking ddI PEDIATRIC ORAL SUSPENSION:

  • Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid. For patients taking ddI FOR ORAL SOLUTION:
  • Open the foil packet and pour its contents into approximately 1/2 glass (4 ounces) of water. DO NOT MIX WITH FRUIT JUICE or other acid-containing drinks.
  • Stir for approximately 2 to 3 minutes until the powder is dissolved.
  • Drink at once.

For patients taking ddI TABLETS:

  • Tablets should be thoroughly chewed or crushed or mixed in at least 1 ounce of water before swallowing. The tablets are hard and some people may find them difficult to chew. If the tablets are mixed in water, stir well until a uniform suspension is formed and take at once.

  • TWO TABLETS MUST BE TAKEN TOGETHER BY PATIENTS OVER 1 YEAR OF AGE. These tablets contain a special buffer to keep ddI from being destroyed in the stomach. In order to get the correct amount of buffer, 2 tablets always need to be taken together. Infants from 6 to 12 months of age will get enough buffer from just 1 tablet.

ddI should be taken on an empty stomach since food may decrease the absorption in the stomach and keep it from working properly. ddI should be taken at least 2 hours before or 2 hours after you eat.

This medicine works best when there is a constant amount in the blood. To help maintain a constant level, do not miss any doses. If you need help in planning the best times to take your medicine, check with your health care professional.

Dosing:
The dose of ddI will be different for different patients. Be sure to follow your doctor's orders or the directions on the label. The following information includes only the average doses of ddI.
If your dose is different, do not change it unless your doctor tells you to:

The number of tablets or teaspoonfuls of solution or suspension that you take depends on the strength of the medicine.

  • For the treatment of advanced HIV infection or AIDS:
    -- For ORAL dosage form (solution):
  • Adults and teenagers -- Dose is based on body weight. -- For patients weighing less than 60 kilograms (kg) (132 pounds):
    167 milligrams (mg) every twelve hours. -- For patients weighing 60 kg (132 pounds) or more:
    250 mg every twelve hours.
  • Children -- The oral solution is usually not used for small children.

    -- For ORAL dosage form (pediatric suspension):

  • Adults and teenagers -- The pediatric oral suspension is usually not used in adults and teenagers.
  • Children -- Dose is based on body size and must be determined by your doctor. The dose usually ranges from 31 to 125 mg every eight to twelve hours.

    -- For ORAL dosage form (tablets):

  • Adults and teenagers -- Dose is based on body weight. -- For patients weighing less than 60 kg (132 pounds):
    125 mg every twelve hours. -- For patients weighing 60 kg (132 pounds) or more:
    200 mg every twelve hours.
  • Children -- Dose is based on body size and must be determined by your doctor. The dose usually ranges from 25 to 100 mg every eight to twelve hours.

Missed dose:
If you do miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Only take medicine that your doctor has prescribed specifically for you. Do not share your medicine with others.

Storage:
To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.


Precautions While Using ddI

It is extremely improtant for your doctor to check your progress at regular intervals.

Never take any other mecications without frist checking with your doctor, doing so may increase the chance of side effects from ddI.


Side Effects of ddI

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Call your doctor immediately if any of the following side effects occur:

Less common


  • Nausea and vomiting; stomach pain; tingling, burning, numbness, and pain in the hands or feet

Rare


  • Convulsions (seizures); fever and chills; shortness of breath; skin rash and itching; sore throat; swelling of feet or lower legs; unusual bleeding and bruising; unusual tiredness and weakness; yellow skin and eyes

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common


  • Anxiety; diarrhea; difficulty in sleeping; dryness of mouth; headache; irritability; restlessness

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

DISCLAIMER: The information about drugs featured by HIVpositive.us is general in nature and is intended for educational use. It does not cover all possible uses, actions, precautions, side effects, or interactions of any medicines, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular drug.
See "Full Disclaimer."

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