Children

ddI (didanosine, Videx / VidexEC) is safe and effective for use in children aged two weeks and over.1 2 3

In 2008, the US FDA approved the use of Videx EC delayed-release caplets to include children weighing at least 20 kilograms. In children 20 to <25kg, 200mg once daily is advised. Children weighing 25 to <60kg should take 250mg once daily.

For patients weighing less than 20 kilograms, the recommended dose of didanosine powder for oral solution is based on age and body surface area:

  • Patients aged two weeks to eight months should receive 100mg/m2 twice daily.
  • Patients older than eight months should receive 120mg/m2 twice daily. One study has found that half of this dose may be appropriate for children under four months of age.4

The oral solution of ddI contains antacids and may effect the metabolism of other drugs being used.

In all patients with renal impairment, dosing interval and dosing reductions should be made according to the manufacturer's prescribing information.

Stavudine (d4T) used with ddI may produce enhanced toxicity and is not advised unless the potential benefit outweighs the risk. Adverse events could include pancreatitis and peripheral neuropathy. If d4T is co-administered with tenofovir, it can be taken with a light meal.

References

  1. Englund JA et al. Zidovudine, didanosine, or both as the initial treatment for symptomatic HIV-infected children. N Engl J Med 336: 1704-1712, 1997
  2. McKinney RE et al. A randomized study of combined zidovudine-lamivudine versus didanosine monotherapy in children with symptomatic therapy-naive HIV-1 infection. J Pediatr 133: 500-508, 1998
  3. Solder B et al. Effect of antiretroviral combination therapy (zidovudine / didanosine or zidovudine / lamivudine) on quantitative plasma human immunodeficiency virus-ribonucleic acid in children and adolescents infected with human immunodeficiency virus. J Pediatr 130: 293-299, 1997
  4. Kovacs A et al. Pharmacokinetics of didanosine and drug resistance mutations in infants exposed to zidovudine during gestation or postnatally and treated with didanosine or zidovudine in the first three months of life. Pediatr Infect Dis J 24: 503-509, 2005
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.