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Generic Videx EC ( Didanosine )
Videx EC (didanosine, also known as ddI) is a delayed‑release enteric‑coated capsule formulation of didanosine, a nucleoside reverse transcriptase inhibitor (NRTI) of the adenosine analogue class. It is indicated in combination with other antiretroviral agents for the treatment of human immunodeficiency virus type 1 (HIV‑1) infection in adults and children who can swallow capsules. Didanosine is phosphorylated intracellularly to its active metabolite, dideoxyadenosine triphosphate, which inhibits HIV‑1 reverse transcriptase by competing with natural adenosine triphosphate and by incorporating into viral DNA, causing chain termination. Due to significant toxicities, including pancreatitis, peripheral neuropathy, and lactic acidosis, didanosine is no longer a preferred first‑line agent in Canada and is reserved for patients with limited treatment options. It must always be used as part of a multi‑drug antiretroviral regimen.
Usual adult dose: For adults weighing 60 kg or more, the recommended dose is 400 mg once daily. For adults weighing less than 60 kg, the dose is 250 mg once daily. Videx EC capsules must be swallowed whole with at least 100 mL of water on an empty stomach, at least 2 hours before or 2 hours after a meal; food reduces the absorption of didanosine significantly. The capsules must not be opened, crushed, or chewed, as the enteric coating protects the drug from degradation by gastric acid. Dose reduction is required in renal impairment. If a dose is missed, the patient should take it as soon as remembered, but two doses must not be taken at the same time. Didanosine is never used as monotherapy.
Dosage form: Enteric‑coated (delayed‑release) capsules: 400 mg (white, opaque, imprinted with “BMS 400 mg” and “6672”). Also available as 125 mg, 200 mg, and 250 mg strengths. The 400 mg capsule is the standard daily dose for patients weighing 60 kg or more.
Onset of action: Didanosine is rapidly absorbed after oral administration of the enteric‑coated capsule, with peak plasma concentrations reached approximately 2 hours post‑dose. Antiretroviral activity, measured by a decline in HIV‑1 RNA, is evident within the first weeks of therapy when combined with other active drugs; maximal viral suppression typically requires 12 to 24 weeks of consistent adherence.
Duration of action: The intracellular half‑life of the active triphosphate is approximately 25 hours, permitting once‑daily dosing. The elimination half‑life of didanosine in plasma is about 1.5 hours, but the pharmacodynamic effect persists much longer due to the sustained intracellular concentration of the active metabolite.
Alcohol recommendation: Alcohol must be avoided during treatment with didanosine. Both chronic and binge alcohol consumption increase the risk of pancreatitis, a potentially fatal adverse effect already associated with didanosine. In addition, alcohol may exacerbate the hepatic steatosis and lactic acidosis that are known to occur with NRTI therapy. Patients should be counselled on complete abstinence from alcohol while on this medication.
Most common side effects: Diarrhea, nausea, vomiting, abdominal pain, headache, and rash. The most serious toxicities are pancreatitis (sometimes fatal), lactic acidosis with hepatic steatosis, and dose‑limiting peripheral neuropathy. Patients must be monitored for signs of pancreatitis (elevated amylase/lipase, severe abdominal pain, nausea) and for symptoms of neuropathy (numbness, tingling, or burning pain in the hands and feet). Liver function tests, serum electrolytes, and acid‑base balance should be monitored regularly. In patients co‑infected with hepatitis B or C, or in those with elevated baseline liver enzymes, the risk of hepatic decompensation is increased. Retinal changes and optic neuritis have been reported in children; periodic ophthalmologic evaluation is recommended. Didanosine should not be co‑administered with allopurinol, ribavirin, or stavudine due to serious drug interactions. Immune reconstitution inflammatory syndrome (IRIS) may occur following the initiation of combination antiretroviral therapy. Didanosine is a pregnancy category B drug, but lactic acidosis has been reported in pregnant women receiving didanosine and stavudine together; this combination must be avoided. Videx EC is available only by prescription and must be initiated and supervised by a healthcare professional experienced in HIV management.
Would you like to try Videx EC (Didanosine) without a prescription?
+ Package delivery insurance
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+ Package delivery insurance
+ Next orders 10% discount
+ Package delivery insurance
+ Next orders 10% discount
