Drug General Information (ID: DDIS1N3WUE)
  Drug Name Didanosine Drug Info Delafloxacin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anti-Hiv Agents Quinolones/Antibiotics
  Structure

 Mechanism of Didanosine-Delafloxacin Interaction (Severity Level: Moderate)
     Complex formation Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Didanosine Delafloxacin
      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 Delafloxacin 

Recommended Action
      Management Quinolones such as ciprofloxacin should be administered at least 2 hours before or 6 hours after didanosine buffered tablets or pediatric oral solution, and patients should be monitored for potentially decreased antimicrobial efficacy during concomitant therapy. Didanosine buffered powder for oral solution, which uses a citrate-phosphate buffer, and the delayed-release capsules, which are not buffered, are not expected to cause this interaction.

References
1 Deppermann KM, Lode H "Fluoroquinolones: interaction profile during enteral absorption." Drugs 45 Suppl 3 (1993): 65-72. [PMID: 7689454]
2 Nicolau D, Quintiliani R, Nightingale CH. Ofloxacin vs ciprofloxacin: a comparison [published correction appears in Conn Med 1992 Nov;56(11):652]. Conn Med. 1992;56(5):261-263. [PMID: 1611900]
3 Knupp CA, Barbhaiya RH "A multiple-dose pharmacokinetic interaction study between didanosine (videx(r)) and ciprofloxacin (cipro(r)) in male subjects seropositive for HIV but asymptomatic." Biopharm Drug Dispos 18 (1997): 65-77. [PMID: 9008270]
4 Marchbanks CR "Drug-drug interactions with fluoroquinolones." Pharmacotherapy 13 (1993): s23-8. [PMID: 8474934]
5 Mizuki Y, Fujiwara I, Yamaguchi T "Pharmacokinetic interactions related to the chemical structures of fluoroquinolones." J Antimicrob Chemother 37 Suppl A (1996): 41-55. [PMID: 8737124]
6 Nix DE, Watson WA, Lener ME, et al "Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacin." Clin Pharmacol Ther 46 (1989): 700-5. [PMID: 2598571]
7 Polk RE "Drug-drug interactions with ciprofloxacin and other fluoroquinolones." Am J Med 87 (1989): s76-81. [PMID: 2686430]
8 Product Information. Baxdela (delafloxacin). Melinta Therapeutics, Lincolnshire, IL.
9 Product Information. Cipro (ciprofloxacin). Bayer, West Haven, CT.
10 Product Information. Videx (didanosine). Bristol-Myers Squibb, Princeton, NJ.
11 Sahai J "Avoiding the ciprofloxacin-didanosine interaction." Ann Intern Med 123 (1995): 394-5. [PMID: 7625638]
12 Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G "Cations in the didanosine tablet reduce ciprofloxacin bioavailability." Clin Pharmacol Ther 53 (1993): 292-7. [PMID: 8453847]
13 Shiba K, Sakamoto M, Nakazawa Y, Sakai O "Effects of antacid on absorption and excretion of new quinolones." Drugs 49(Suppl 2) (1995): 360-1. [PMID: 8549362]
14 Damle BD, Mummaneni V, Kaul S, Knupp C "Lack of Effect of Simultaneously Administered Didanosine Encapsulated Enteric Bead Formulation (Videx EC) on Oral Absorption of Indinavir, Ketoconazole, or Ciprofloxacin." Antimicrob Agents Chemother 46 (2002): 385-91. [PMID: 11796346]