Lactic acidosis, hepatitis and liver failure have been reported with the use of nucleoside analogues, including Videx. Other important toxicities include retinal changes, optic neuritis, and peripheral neuropathy. Patients treated with Videx in combination with Zerit , with or without hydroxyurea , may be at increased risk for adverse events such as pancreatitis, peripheral neuropathy, and liver failure. The preferred dosing frequency is twice a day since there is more evidence supporting the efficacy of this dosing. Many patients find it difficult to take ddI due to its unpalatable nature and the food restrictions.
Stomach acidity decreases the drug's absorption.
Hence the drug needs to be taken 30 minutes before or 2 hours after eating. The tablets are also given with a buffer to protect it from being degraded by the stomach's acid, and can not be taken with indinavir , which is degraded by the buffer. Other drugs may also interact with the buffer used in the tablets. A new enteric coated formulation of the drug allows patients to take a single pill once a day, but with the same food restrictions. Data showing it is synergistic with d4T and hydroxurea, and approval for once-daily dosing have raised the drug's profile.