Abstract
The combination of tenofovir and didanosine results in an increase in the didanosine plasma exposure and might augment the risk for didanosine toxicity. Although pharmacokinetic studies support a didanosine dose reduction to 250 mg when used concurrently with tenofovir in patients weighing at least 60 kg, no data are available in lower-weight patients. We describe a case of lactic acidosis and acute liver failure in a low-weight patient receiving tenofovir and a reduced dose of didanosine (200 mg/day). To our knowledge, this is the first case of severe toxicity associated with a reduced dose schedule of didanosine. Previous cases of severe toxicity associated with the combination of tenofovir and didanosine are reviewed.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Acidosis, Lactic / chemically induced
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Acute Disease
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Adenine / administration & dosage
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Adenine / adverse effects
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Adenine / analogs & derivatives*
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Anti-HIV Agents / administration & dosage
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Anti-HIV Agents / adverse effects*
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Didanosine / administration & dosage
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Didanosine / adverse effects*
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Drug Therapy, Combination
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Female
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HIV Infections / drug therapy*
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HIV-1 / drug effects
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Humans
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Liver Failure / chemically induced
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Male
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Middle Aged
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Organophosphonates / administration & dosage
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Organophosphonates / adverse effects*
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Reverse Transcriptase Inhibitors / administration & dosage
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Reverse Transcriptase Inhibitors / adverse effects*
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Tenofovir
Substances
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Anti-HIV Agents
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Organophosphonates
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Reverse Transcriptase Inhibitors
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Tenofovir
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Adenine
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Didanosine