Tetracyclines Didanosine

DIDANOSINE TETRACYCLINES 1 efficacy of tetracycline, and possibly demedocydine, doxycydine, lymecydine, minocycline and oxytetracydine with buffered didanosine Absorption may be affected by the buffered didanosine formulation, which t gastric pH Avoid co-administration with buffered didanosine preparations. Consider changing to enteric-coated didanosine tablets... 

Alcohol, amiodarone, didanosine, 1-asparaginase, piroxicam, stavudine, tamoxifen, tetracycline derivatives, valproic acid, and zidovudine... 

Azithromycin, fluoroquinolones, ketoconazole, isoniazid, penicillin, rifampin, and tetracycline ° Didanosine, indinavir, stavudine, and zidovudine ° Aledronate, risedronate, and levodopa... 

Buffering agents that are compounded with didanosine to counteract its degradation by gastric acid may interfere with the absorption of other drugs that require acidity (e.g., indinavir, delavirdine, ketoconazole, fluoroquinolones, tetracyclines, dapsone). An enteric-coated formulation Videx EC) that dissolves in the basic pH of the small intestine is not susceptible to these interactions. Ganciclovir and valganciclovir can increase blood levels of didanosine. The use of zalcitabine with didanosine is not recommended because that combination carries an additive risk of peripheral neuropathy. The combination of didanosine with stavudine increases the risk of pancreatitis, hepatotoxicity, and peripheral neuropa-... 

Didanosine (ddl) NRTT1 Tablets, 400 mg daily,3 adjusted for weight. 30 min before or 2 h after meals. Separate dosing from fluoroquinolones and tetracyclines by 2 h Peripheral neuropathy, pancreatitis, diarrhea, nausea, hyperuricemia. Possible increase in myocardial infarction Avoid concurrent neuropathic drugs (eg, stavudine, zalcitabine, isoniazid), ribavirin, and alcohol. Do not administer with tenofovir... 

Fluoroquinolones and tetracyclines should be administered at least 2 hours before or after didanosine in order to avoid decreased antibiotic plasma concentrations due to chelation. Coadministration with ganciclovir results in an increased AUC of didanosine and a decreased AUC... 

Steatosis Amiodarone, steroids, tetracycline, sodium valproate, tamoxifen, TPN, didanosine... 

Some of the didanosine preparations (e.g. chewable tablets) are formulated with antacid buffers that are intended to facilitate didanosine absorption by minimising acid-induced hydrolysis in the stomach. These preparations can therefore alter the absorption of other drugs that are affected by antacids (e.g. azole antifungals, quinolone antibacterials, tetracyclines). This interaction may be minimised by separating administration by at least 2 hours. Alternatively, the enteric-coated preparation of didanosine (gastro-resistant capsules) may be used. 

---