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Very scared...folllow up on Viread/Videx
Dec 22, 2002

I am following up on a questions someone asked you regarding Viread, Virimune and Videx (posted December 20th) where you stated the following:

"As a result, newer studies were conducted to look at the combination using the lower dose of didanosine, 250 mg-- the dose that your doctor has prescribed. Long story short, it appears that the two medications can be taken together, without regard to meals, and has drug levels that are comparable to normal. The differences that you allude to are probably not clinically significant, since there is a lot of person to person variation in levels."

I was just given a prescription that consists of Viread, Videx (EC 400MG) as Sustiva (600MG). My doctor doesn't seemed to be concerned about the dietary restrictions..and said I can take the Viread, Videx and Sustiva all at the same time (which I will do at 11:00PM..at least two hours after any meal). Your answer seems to be similiar to his, but other people/resources on this website completely contradict this..stating things like: 1) Videx and Viread should not be taken together if at all possible. 2) Videx and Viread should be taken at least two hours apart. 3) Viread needs to be taken with food.

All three contradict my doctors prescription....not to mention that my doctor still feels comfortable with the Videx EC 400MG as oppossed to the 250MG. I am terrified of the warnings, but want to trust my doctor. My questions is.....what is someone to do in this situation? At the moment, I have no symptoms of HIV with a Tcell count that hovers between 700-1200. Please advise in detail.

Thanks!

Response from Dr. Young

Thank you for your question.

The data that I've cited comes directly from Gilead (the manufacturer of tenofovir) and Bristol Myers Squibb (the makers of Videx EC). Your doctor is correct in the dietary and dose-timing statements (the previous ones were derived from the old data set, using the higher doses). I'd suggest that your doctor contact his/her Gilead or BMS representative for an update about the dosing of the two medications. Many patients have received the higher dose without serious complications, but in our practice, for example, all of the persons who took the higher dose (as instruced in the older product package insert) developed either clinical or laboratory evidence of pancreatitis.

So again, for point of clarity: Viread (tenofovir, 300 mg) can be taken with Videx EC (didanosine, 250 mg) together without regards to meals. The higher dose of didanosine (400mg)is not recommended because of increased drug levels and the risk of developing significant toxicity. -BY



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