Didanosine is a drug used in the treatment against infection with the HIV virus. The active ingredient belongs to the virus-inhibiting agents and thereby serves to strengthen the immune system of HIV patients.
What is didanosine?
Didanosine is a drug that is used in the treatment against infection with the HIV virus. Didanosine generally strengthens the body’s defenses of HIV patients, inhibits the multiplication of HIV viruses and lowers their number in the blood, can prevent and in some cases even fight AIDS. Didanosine is a non-acid-stable drug, which is why it is destroyed by stomach acid. For this reason, didanosine is administered only as an enteric-coated capsule or even in combination with acid-binding agents. Didanosine itself is a so-called nucleoside reverse transcriptase inhibitor (NRTI) and, as a drug precursor (prodrug), is not effective against viruses on its own.
Pharmacologic action
Only in the patient’s body is didanosine converted to the actual active ingredient, where it inhibits the enzyme reverse transcriptase, thereby suppressing the replication of HIV viruses. By lowering the number of viruses in the blood, the body’s immune defenses are also strengthened again. Since HIV is a very adaptable virus and thus quickly develops a resistance to individual substances, the active ingredient is usually used in combination with other active ingredients in the treatment of HIV patients. It is possible to combat the disease AIDS or at least delay its onset with the active ingredient didanosine. Didanosine cannot cure the disease, but it can improve quality of life and increase life expectancy.
Medical application and use
If the patient has hypersensitivity to the active ingredient didanosine, the drug should not be used. It should be used only after careful consideration of risk as well as benefit by the treating physician in patients with HIV infection who have liver disease, enlarged liver, or hepatitis. Patients must be under the strictest supervision throughout treatment, especially overweight women. Patients with a malfunction in certain cell organelles (called mitochondria) also require special monitoring. Caution should also be exercised in HIV patients who have or have had pancreatitis. If liver or kidney function is impaired, the dose must be adjusted accordingly. Trained physicians are then required to supervise treatment if HIV patients have concomitant infection with hepatitis B or hepatitis C viruses, as treatment then carries additional risks. During pregnancy, didanosine – like many other drugs – should be prescribed only after careful consideration of the risk-benefit ratio. However, animal experiments have shown a harmful effect on the unborn child, although these experiments cannot be transferred to the human organism. Didanosine should therefore be avoided as far as possible during the first three months of pregnancy, as there is also an increased risk of a rise in blood lactic acid levels during pregnancy. Therefore, the care of pregnant women with HIV infection should also be provided only by experienced physicians. As a general rule, a woman infected with HIV should not breastfeed her newborn, because the virus enters breast milk and is thus transmitted to the child. If a newborn is infected with the HI virus, it should be treated with didanosine only after three months, if possible, because there is insufficient knowledge about the effect for infants under three months. From the age of three months, treatment with a dose corresponding to the child’s body weight or even body surface area is possible on an individual basis according to the course of the disease. Particularly in children, care should always be taken to ensure that treatment is given with care and under medical supervision.
Risks and side effects
Didanosine, as an agent against HIV and AIDS, has side effects such as diarrhea, malaise, abdominal pain, headache, fatigue, nausea associated with vomiting, hives and rash, hepatitis, jaundice, dry mouth, anemia, hair loss.Other side effects are known, which may occur more or less frequently and vary from patient to patient. Especially in patients with AIDS, it is often difficult to distinguish between disease-related reactions and drug-related side effects. Medications containing the active ingredient didanosine should be taken at least two hours apart from other medications and meals so as not to reduce the absorption of the active ingredient. The treating physician knows which medications should not be taken at the same time.
