Antiretroviral agents that have been shown to associate with abnormal glucose and lipid metabolism and lipodystrophy in HIV-infected adults are old generation PIs, such as indinavir and ritonavir, and thymidine NRTIs, such as stavudine, zidovudine, and didanosine
[52-55, 57, 58].
This analysis also assessed the impact of five individual nucleoside antiretrovirals on development of cardiomyopathy--Retrovir (zidovudine), Videx (didanosine
), Zerit (stavudine), Ziagen (abacavir), and Hivid (zalcitabine) (Hivid is no longer used).
Under the terms of the agreement, Matrix Laboratories will secure World Health Organization (WHO) prequalification for all products covered by the agreement, including pediatric formulations of didanosine
and, in the future, atazanavir powder formulation for pediatric use when Bristol-Myers Squibb's product is available.
Cases of non-cirrhotic portal hypertension have been reported in adults and children with HIV who are taking the antiretroviral drug didanosine
, including some fatal cases, according to the FDA.
: Nervousness, anxiety, confusion, insomnia.
A recent study from southern India showed if viral load monitoring is not available, severe resistance mutations occur to the current first line HAART regimens and these might jeopardize future second line nucleoside reverse transcriptase inhibitors (NRTI) drugs (tenofovir, abacavir, didanosine
) and also the newer non NRTI (NNRTI) drugs (etravirine and TMC278) under development.
Although certain drugs, for example indinavir, lopinavir, abacavir and possibly didanosine
, are associated with an increased risk of cardiovascular events, the event rates are still lower than that seen in untreated patients and should not be a valid reason for deferring ART.
On hospital day 13, the patient began treatment with zidovidine, lamuvidine, didanosine
, and nevirapine.
The most common regimens employed were the following triple therapies: (a) Zidovudine, Lamivudine, and Efavirenz (39% of patients); (b) Zidovudine, Lamivudine, and Nelfinavir (17%); (c) Stavudine, Lamivudine, and Nelfinavir (10%); (d) Zidovudine, Didanosine
, and Nelfinavir (8%); (e) Zidovudine, Didanosine
, and Efavirenz (4%); (f) Didanosine
, Stavudine, and Nelfinavir (4%); and (g) Lamivudine, Stavudine, Efavirenz (4%).
One of these had a possible alcohol association, and in 8 patients on antiretroviral therapy with didanosine
and stavudine these drugs were thought to be responsible for the pancreatitis.
HAART (indinavir, stavudine and didanosine
) was initiated in April 2002.
Drug-drug interactions include probenicid, sucralfate, antacids containing aluminum or magnesium, iron, multivitamins containing metal cations, and didanosine
. The safety and effectiveness of gemifloxacin in children, adolescents (less than 18 years of age), pregnant women, and lactating women have not been established.