Severe toxicity associated with the combination of tenofovir and didanosine: case report and review

Int J STD AIDS. 2005 Sep;16(9):646-8. doi: 10.1258/0956462054944480.

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

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acidosis, Lactic / chemically induced
  • Acute Disease
  • Adenine / administration & dosage
  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects*
  • Didanosine / administration & dosage
  • Didanosine / adverse effects*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / drug therapy*
  • HIV-1 / drug effects
  • Humans
  • Liver Failure / chemically induced
  • Male
  • Middle Aged
  • Organophosphonates / administration & dosage
  • Organophosphonates / adverse effects*
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / adverse effects*
  • Tenofovir

Substances

  • Anti-HIV Agents
  • Organophosphonates
  • Reverse Transcriptase Inhibitors
  • Tenofovir
  • Adenine
  • Didanosine