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Precautions and Warnings With Didanosine

There are several precautions and warnings with didanosine to be aware of before starting the drug. These include knowing how the medication can affect people with liver disease, potential drug interactions, and the possibility of the medication being passed through breast milk. It is also important to talk to your healthcare provider about any other health conditions you may have, such as kidney disease, gout, and any allergies.

Didanosine: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking didanosine (Videx®) if you have:
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Gout
  • Kidney stones
  • Kidney disease, such as kidney failure (renal failure)
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about any other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Didanosine

Some warnings and precautions to be aware of prior to taking didanosine include the following:
  • Didanosine can cause inflammation of the pancreas (pancreatitis), which can be very dangerous. Let your healthcare provider know immediately if you have any signs of pancreatitis, such as:


    • A tender or swollen abdomen
    • Nausea and vomiting
    • Fever
    • A rapid heart rate (tachycardia)
    • Rapid breathing.


  • Rarely, didanosine can cause lactic acidosis and hepatic steatosis. These conditions are caused by damage to the liver and can be very dangerous. You are at a higher risk for these conditions if you have liver disease.
  • Be sure to tell your healthcare provider right away if you notice any vision changes. It is probably a good idea to have regular eye examinations while taking didanosine.
  • Didanosine can cause liver damage. Be sure to let your healthcare provider know if you already have liver disease, as this may increase your risk of further liver damage.
  • Didanosine can cause nerve problems (known as peripheral neuropathy). Often, these nerve problems cause unusual sensations, such as numbness, burning, or tingling.
  • Didanosine can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and you may lose weight in other areas.
  • Didanosine can increase the level of uric acid in your blood, which may increase your risk of gout or kidney stones.


  • When you first start taking this medication and your immune system begins to recover, a group of problems known as immune reconstitution syndrome may occur. Your immune system may start aggressively reacting to any infections you may have and may cause extreme inflammation. There have even been cases of autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barré syndrome) possibly caused by this problem. 


  • There have been a few cases of portal hypertension associated with didanosine. Some of these cases were severe enough to result in liver transplantation or even death. Portal hypertension (high blood pressure in the portal vein, the blood vessel that carries blood from the intestines and spleen to the liver) can be dangerous. Your healthcare provider should monitor you regularly for signs of this problem by using routine blood tests and checking for spleen enlargement. 


  • The kidneys help remove didanosine from the body. If you have kidney disease, you may need a lower didanosine dosage.
  • Didanosine is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, regardless of whether you are taking medications.
  • As with all HIV medications, it is important that you take didanosine exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
  • Didanosine can interact with a few different medications (see Drug Interactions With Didanosine for more information).
  • Didanosine is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known (see Videx and Pregnancy).
  • It is not known if didanosine passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Videx and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.

Didanosine -- HIV Drug Information

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