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

Mechanism of Didanosine-Ganciclovir Interaction (Severity Level: Moderate)
Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph
Drug Name		Didanosine				Ganciclovir
Mechanism		Didanosine				Competitive inhibition of renal tubular secretion of didanosine
Key Mechanism Factor 1
		Factor Name		Renal tubular secretion
		Factor Description		Renal tubular secretion allows selective transfer of substances from the blood around the capillaries into the renal tubules via filtrate. Drug excretion may be reduced when two drugs compete for renal tubular secretion.
Mechanism Description		Decreased elimination of Didanosine caused by Ganciclovir mediated competitive inhibition of renal tubular secretion

Recommended Action
Management		Close monitoring for toxicities associated with didanosine such as pancreatitis, lactic acidosis, and peripheral neuropathy is recommended during concurrent therapy. Patients should be advised to promptly notify their physician if they experience possible symptoms of toxicity (e.g., abdominal pain, nausea, vomiting, diarrhea, weakness, dizziness, lightheadedness, irregular heartbeat, or numbness, pain, or tingling in the hands and feet).

References
1	Product Information. Cytovene (ganciclovir). Genentech, South San Francisco, CA.
2	Taburet AM, Singlas E "Drug interactions with antiviral drugs." Clin Pharmacokinet 30 (1996): 385-401. [PMID: 8743337]
3	Lim CF, Stockigt JR, Curtis AJ, Wynne KN, Barlow JW, Topliss DJ. A naturally occurring furan fatty acid enhances drug inhibition of thyroxine binding in serum. Metabolism. 1993 Nov;42(11):1468-74.