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Didanosine is a drug that blocks reproduction of the human immunodeficiency virus (HIV). HIV is the virus that infects people causing acquired immunodeficiency syndrome (AIDS). Didanosine is used in combination with other drugs to treat HIV infection.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Acetyl-L-carnitine |
| May be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
Acetyl-L-carnitine Riboflavin |
| May be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better. |
Shiitake* |
| Reduced drug absorption/bioavailability |
None known |
| Adverse interaction |
None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Interactions with Dietary Supplements
Riboflavin
Persons with AIDS have developed lactic acidosis and fatty liver while taking didanosine and
other drugs in its class. Didanosine can inhibit crucial DNA-related riboflavin activity,
which may be normalized by riboflavin supplementation. A 46-year-old woman with AIDS and
lactic acidosis received a single dose of 50 mg of riboflavin, after which her laboratory
tests returned to normal and her lactic acidosis was completely resolved.1 More
research is needed to confirm the value of riboflavin for preventing and treating this side
effect.
Acetyl-L-carnitine
Severe peripheral neuropathy (painful sensations due to nerve damage in the hands and feet)
often develops in people taking didanosine or other drugs in its class. People with peripheral
neuropathy who were taking one of these drugs were found to be deficient in
acetyl-L-carnitine.2 In a preliminary trial, supplementation with 1,500 mg of
acetyl-L-carnitine twice a day resulted in improvement in the neuropathy after six months in
people taking didanosine or related drugs.3
Interactions with Herbs
Shiitake (Lentinas
edodes)
Lentinan is a complex sugar found in shiitake mushrooms and is recognized as an immune
modulator. In an early human trial, 88 HIV-infected people received didanosine (400 mg per
day) plus a 2 mg lentinan injection per week.4 Didanosine-lentinan combination
therapy improved CD4 immune cell counts for a significantly longer period than didanosine
alone. Lentinan is under investigation as an adjunct therapy to be used with didanosine for
HIV infection.5 Oral preparations of shiitake are available, but it is not known if
they would be an effective treatment with didanosine for HIV infection.
Interactions with Foods and Other Compounds
Food
Didanosine should be taken on an empty stomach, one hour before or two hours after eating
food.6
References
1. Fouty B, Frerman F, Reves R. Riboflavin to treat nucleoside analogue-induced lactic acidosis. Lancet 1998;352:291–2 [letter].
2. Famularo G, Moretti S, Marcellini S, et al. Acetyl-carnitine deficiency in AIDS patients with neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS 1997;11:185–90.
3. Hart AM, Wilson AD, Montovani C, et al. Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy. AIDS2004;18:1549–60.
4. Gordon M, Guralnik M, Kaneko Y, et al. A phase II controlled study of a combination of the immune modulator, lentinan, with didanosine (ddI) in HIV patients with CD4 cells of 200–500/mm3. J Med 1995;26:193–207.
5. Threlkeld DS, ed. News, Keeping Up, December 1994, Lentinan. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Dec 1997, 805.
6. Threlkeld DS, ed. Anti-Infectives, Antiviral Agents, Didanosine. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 406k–6t.
