Drug interactions
Didanosine + Tenofovir df
Severity: Major
Didanosine and Tenofovir df: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tenofovir raises didanosine plasma exposure, increasing the risk of didanosine toxicities such as pancreatitis, lactic acidosis and peripheral neuropathy. Combined use has also been associated with blunted CD4 recovery and virologic failure in some regimens.
What this interaction means in plain words
Didanosine and Tenofovir df can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Tenofovir increases didanosine concentrations, probably via inhibition of purine nucleoside phosphorylase and competition for renal elimination.
What to do
Avoid the combination where possible and choose an alternative nucleoside backbone. If unavoidable, reduce the didanosine dose per labeling and monitor for pancreatitis, neuropathy, lactate and CD4 count.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Didanosine
- Didanosine + Elvitegravir / cobicistat / emtricitabine / tenofovir df Contraindicated
- Didanosine + Hydroxycarbamide Contraindicated
- Didanosine + Ribavirin Contraindicated
- Didanosine + Stavudine Contraindicated
- Allopurinol + Didanosine Major
- Atidarsagene autotemcel + Didanosine Major
Frequently asked questions
Can I take Didanosine with Tenofovir df?
MediHelp rates the interaction as major. Didanosine and Tenofovir df can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Tenofovir raises didanosine plasma exposure, increasing the risk of didanosine toxicities such as pancreatitis, lactic acidosis and peripheral neuropathy. Combined use has also been associated with blunted CD4 recovery and virologic failure in some regimens.
How serious is the interaction between Didanosine and Tenofovir df?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and choose an alternative nucleoside backbone. If unavoidable, reduce the didanosine dose per labeling and monitor for pancreatitis, neuropathy, lactate and CD4 count.
What other medicines interact with Didanosine?
MediHelp also lists interactions of Didanosine with, for example, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Hydroxycarbamide, Ribavirin. The full list is on the Didanosine page.
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