.
Didanosine is a drug that blocks reproduction of the human immunodeficiency virus (HIV). HIV is the virus that infects people causing acquired immunodeficiency syndrome (AIDS). Didanosine is used in combination with other drugs to treat HIV infection.
Interactions with Dietary Supplements
Riboflavin
Persons with AIDS have developed lactic acidosis and fatty liver while taking didanosine and
other drugs in its class. Didanosine can inhibit crucial DNA-related riboflavin activity,
which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and
lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory
tests returned to normal and her lactic acidosis was completely resolved.1 More
research is needed to confirm the value of riboflavin for preventing and treating this side
effect.
Acetyl-L-Carnitine
Severe peripheral neuropathy (painful sensations due to nerve damage in the hands and feet)
often develops in people taking didanosine and drugs in its class. People with peripheral
neuropathy who were taking didanosine were found to be deficient in
acetyl-L-carnitine.2 Some researchers have suggested that supplementing
acetyl-L-carnitine may assist in managing this condition.3
Interactions with Herbs
Shiitake (Lentinas
edodes)
Lentinan is a complex sugar found in shiitake mushrooms and is recognized as an immune
modulator. In an early human trial, 88 HIV-infected people received didanosine (400 mg per
day) plus a 2 mg lentinan injection per week.4 Didanosine-lentinan combination
therapy improved CD4 immune cell counts for a significantly longer period than didanosine
alone. Lentinan is under investigation as an adjunct therapy to be used with didanosine for
HIV infection.5 Oral preparations of shiitake are available, but it is not known if
they would be an effective treatment with didanosine for HIV infection.
Interactions with Foods and Other Compounds
Food
Didanosine should be taken on an empty stomach, one hour before or two hours after eating
food.6
Summary of Interactions for Didanosine
| Depletion or interference | Acetyl-L-Carnitine |
|---|---|
| Adverse interaction | None known |
| Side effect reduction/prevention |
Acetyl-L-Carnitine Riboflavin |
| Supportive interaction | Shiitake* |
| Reduced drug absorption/bioavailability | None known |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Fouty B, Frerman F, Reves R. Riboflavin to treat nucleoside analogue-induced lactic acidosis. Lancet 1998;352:291–2 [letter].
2. Famularo G, Moretti S, Marcellini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 1997;11:185–90.
3. Moyle GJ, Sadler M. Peripheral neuropathy with nucleoside antiretrovirals: risk factors, incidence and management. Drug Saf 1998;19:481–94 [Review].
4. Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200–500/mm3. J Med 1995;26:193–207.
5. Threlkeld DS, ed. News, Keeping Up, December 1994, Lentinan. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Dec 1997, 805.
6. Threlkeld DS, ed. Anti-Infectives, Antiviral Agents, Didanosine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 406k–6t.
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The information presented in VitaminLore is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.