Hydroxycarbamide Didanosine

HYDROXYCARBAMIDE ANTIVIRALS -DIDANOSINE, ZIDOVUDINE t adverse effects with didanosine and possibly zidovudine Additive effects, enhanced antiretroviral activity via 1 intracellular deoxynudeotides Avoid co-administration... 

In a retrospective study of the antiviral activity, immunological effects, and tolerability of hydroxycarbamide in combination with didanosine, mouth ulceration was recorded in eight of the 65 patients and this led to discontinuation in one patient (3). 

The manufacturers of didanosine have a similar recommendation and state that, if concurrent use is unavoidable, there should be close observation. Similarly, other authors recommend temporarily discontinuing didanosine in patients needing systemic pentamidine or sulfonamide-containing regimens. The UK manufacturer of stavudine recommends that patients receiving concurrent treatment with drugs known to cause pancreatitis should be carefully observed, and the US manufacturer specifically recommends caution with combined use of didanosine and stavudine, see NRTIs + NRTIs , p.800. Note that hydroxycarbamide (hydroxyurea) may increase the risk of pancreatitis with didanosine and stavudine, and the combination should probably be avoided, see NRTIs + Hydroxycarbamide , p.799. 

Hydroxycarbamide appears to increase the antiviral activity of NRTIs, particularly didanosine. However, the combination of hy-drosycarbamide and didanosine may carry a higher risk of adverse effects including neuropathy and pancreatitis, especially if stavudine is also given. 

Increasing abdominal pain occurred in a 47-year-old HIV-positive man one month after he started didanosine (his other medications included nevirapine, hydroxycarbamide, aciclovir and lorazepam). He had been treating the pain with paracetamol, and had taken 4 g over 3 days. Severe... 

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