Drug interactions
Didanosine + Tenofovir disoproxil
Severity: Major
Didanosine and Tenofovir disoproxil: major interaction.
Last updated Sources: US FDA label
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 exposure, increasing the risk of didanosine toxicities such as pancreatitis, lactic acidosis and neuropathy. The combination has also been associated with poorer CD4 recovery and virologic failure in some patients.
What this interaction means in plain words
Didanosine and Tenofovir disoproxil 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 exposure, possibly via inhibition of purine nucleoside phosphorylase and altered renal handling.
What to do
Avoid the combination and use an alternative nucleoside. If it cannot be avoided, reduce the didanosine dose per labeling and monitor for pancreatitis, lactic acidosis and virologic response.
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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References
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 disoproxil?
MediHelp rates the interaction as major. Didanosine and Tenofovir disoproxil 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 exposure, increasing the risk of didanosine toxicities such as pancreatitis, lactic acidosis and neuropathy. The combination has also been associated with poorer CD4 recovery and virologic failure in some patients.
How serious is the interaction between Didanosine and Tenofovir disoproxil?
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 and use an alternative nucleoside. If it cannot be avoided, reduce the didanosine dose per labeling and monitor for pancreatitis, lactic acidosis and virologic response.
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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