Interaction Checker
Do Not Coadminister
_ZZDidanosine (ddI)
Allopurinol
Quality of Evidence: Low
Summary:
Coadministration is contraindicated the US product label for didanosine and not recommended in the European product label as didanosine exposure is increased (AUC and Cmax increased by 105% and 71% with didanosine buffered tablets). Patients treated with didanosine who require allopurinol administration should be switched to an alternative treatment regimen.
Description:
Co-administration of allopurinol (a xanthine oxidase inhibitor) with didanosine is not recommended. Co-administration of didanosine and allopurinol results in increased systemic exposure to didanosine, which can result in didanosine-associated toxicity. Patients treated with didanosine who require allopurinol administration should be switched to an alternative treatment regimen. Coadministration of allopurinol (300 mg once daily for 7 days) and didanosine buffered tablets (400 mg single dose on days 1 and 8) to healthy volunteers increased didanosine AUC and Cmax by 105% and 71%.
Videx Summary of Product Characteristics, Bristol-Myers Squibb Pharmaceuticals Ltd, April 2016.
Coadministration is contraindicated because systemic exposures of didanosine are increased, which may increase didanosine-associated toxicity. The effect of allopurinol (300 mg/day for 7 days) on the pharmacokinetics of didanosine (400 mg single dose) was investigated in healthy volunteers (n=14). Didanosine AUC increased 1.13-fold and Cmax increased by 69%. When allopurinol (300 mg/day for 7 days) and a 200 mg single dose of didanosine was studied in 2 subjects with renal impairment, didanosine AUC increased by 312% and Cmax increased by 232%.
Videx Prescribing Information, Bristol-Myers Squibb Co, December 2018.
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