Basic
Informations
Videx EC is an HIV
medications. It is in a category of HIV medications called
nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs prevent
HIV from altering the genetic material of healthy CD4 cells. This
prevents the cells from producing new virus and decreases the amount
of virus in the body.
Videx, manufactured by Bristol-Myers Squibb, was the second drug
approved for the treatment of HIV, and was originally approved as a
chewable or desolvable tablet by the U.S. Food and Drug
Administration in 1991. Videx EC capsules were approved by the FDA
in 2000 and have since replaced Videx tablets.
Generic versions of delayed-release didanosine (similar to Videx
EC), manufactured by Barr Laboratories, are now available. It was
approved by the FDA in December 2004.
Videx EC must be used in combination with at least two other HIV
drugs.
Drugs
Interactions
HIV-positive people must be
very careful about using Videx EC in combination with Viread (tenofovir).
There are two important warnings to know about:
-
Drug regimens consisting
of Sustiva (efavirenz) or Viramune (nevirapine) plus Viread and
Videx EC have been associated with premature drug failure. If
you are receiving Videx EC with either Sustiva or Viramune, you
may want to discuss alternative options with your doctor.
-
Viread increases the
amount of Videx EC in the body. This can increase the risk of
experiencing side effects that can be caused by Videx EC, such
as pancreatitis, peripheral neuropathy, and lactic acidosis. In
turn, if Viread and Videx EC are used together, Videx EC should
be taken at a dose of 250mg once a day (reduced from the usual
daily dose of 400mg a day).
Because there are now a number
of concerns regarding the use of Viread in combination with Videx
EC, many experts recommend avoiding this combination altogether.
Ribavirin (Rebetol; Copegus), one of the two drugs that are often
prescribed to treat hepatitis C, can increase Videx EC levels inside
cells. Researchers have not yet determined the correct dose of Videx
EC for HIV-positive people who are also taking ribavirin to treat
their hepatitis C infection. In turn, it is probably best to avoid
combining these drugs.
Because Videx EC can cause pancreatitis, it should be used carefully
in combination with other drugs that can also cause pancreatitis.
These include intravenous pentamidine and TMP/SMX (Bactrim; Septra).
It is also possible that combining Videx EC with hydroxyurea, a
cancer drug that has been studied as a treatment for HIV, increases
the risk of pancreatitis.
The oral form of Cytovene (ganciclovir), a treatment used to prevent
CMV from recurring in people who have had this disease, can decrease
Videx EC levels in the bloodstream. Videx EC can increase Cytovene
levels in the bloodstream. No dosing recommendations have been made.
Methadone, a drug frequently used to help people recovering from
heroin addiction, can decrease the amount of Videx EC in the
bloodstream. This can result in an HIV drug regimen being less
effective against HIV, which can cause drug resistance.
Combining Videx EC with Zerit, another nucleoside reverse
transcriptase inhibitor (NRTI), may increase the risk of developing
lactic acidosis. This is especially true in HIV-positive pregnant
women who take both of these drugs together. In turn, the U.S. Food
and Drug Administration (FDA) has recommended that HIV-positive
women not take these two drugs together while they are pregnant.
Side
Effects
Lactic acidosis, which can be
fatal, and severe liver problems (fatty liver) have been reported in
people taking nucleoside reverse transcriptase inhibitors (NRTIs).
These problems are more likely to occur in HIV-positive people
taking Zerit (d4T) or Zerit in combination with Videx EC. Contact
your doctor immediately if you experience nausea, vomiting, or
unusual or unexpected stomach discomfort; weakness and tiredness;
shortness of breath; weakness in the arms and legs; yellowing of the
skin or eyes; or pain in the upper stomach area.
Videx EC can cause inflammation of the pancreas (pancreatitis).
Pancreatitis is a rare but serious side effect that can be
life-threatening in some cases. Notify your doctor immediately if
you develop symptoms of pancreatitis, including nausea, vomiting,
diarrhea, and abdominal pain. You should avoid alcohol while you are
taking Videx EC, as alcohol can increase the risk of damage to your
pancreas.
Videx EC is associated with a rare but potentially serious liver
disorder called non-cirrhotic portal hypertension. Patients using
Videx EC should be monitored for early signs of portal hypertension
during routine medical visits.
A common side effect of Videx EC is peripheral neuropathy, which can
result in pain, tingling, numbness, or burning in the hands and/or
feet. Stopping Videx EC and starting another NRTI that does not
usually cause peripheral neuropathy—for example, Retrovir
(zidovudine) or Ziagen (abacavir)—is often the best way to stop
peripheral neuropathy.
Other common side effects include stomach aches, nausea, diarrhea,
dry mouth, and central nervous system effects (e.g., anxiety,
headaches, trouble sleeping, irritability, and restlessness). Very
often, these side effects improve within a few months/weeks of
starting Videx EC.
Damage to the eyes is another serious side effect that can be caused
by Videx EC. This is more likely to occur in HIV-positive children
taking Videx powder or Videx EC.
HIV drug regimens containing NRTIs, including Videx EC, can cause
increased fat levels (cholesterol and triglycerides) in the blood,
abnormal body-shape changes (lipodystrophy; including increased fat
around the abdomen, breasts, and back of the neck, as well as
decreased fat in the face, arms, and legs), and diabetes. These side
effects of HIV drug therapy are reviewed in our lessons on
Lipodystrophy, Facial Lipoatrophy, and Risks To Your Heart
(Hyperlipidemia).
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