Drug General Information (ID: DDILW69TUC)
Drug Name			Didanosine		Drug Info		Lopinavir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Anti-Hiv Agents
Structure

Mechanism of Didanosine-Lopinavir Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Didanosine				Lopinavir
Mechanism		Polyvalent cations				Binds to polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Didanosine due to formation of complexes caused by Lopinavir

Recommended Action
Management		When prescribed in combination with lopinavir-ritonavir oral solution, didanosine should be administered on an empty stomach one hour before or two hours after lopinavir-ritonavir oral solution, which is to be taken with food. Lopinavir-ritonavir tablets can be administered simultaneously with didanosine without food.

References
1	Canadian Pharmacists Association.
2	Cato A, Qian J, Carothers L, et al. "Evaluation of the pharmacokinetic interaction between ritonavir and didanosine." Clin Pharmacol Ther 59 (1996): 144. [PMID: 9715843]
3	Product Information. Kaletra (lopinavir-ritonavir) Abbott Pharmaceutical, Abbott Park, IL.