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Pharmacy World and Science

, Volume 17, Issue 6, pp 218–221 | Cite as

Study on didanosine concentrations in cerebrospinal fluid

Implications for the treatment and prevention of AIDS dementia complex
  • David M. Burger
  • Cees L. Kraayeveld
  • Pieter L. Meenhorst
  • Jan W. Mulder
  • Richard M. W. Hoetelmans
  • Cees H. W. Koks
  • Jos H. Beijnen
Practice/Case Reports

Abstract

It has been hypothesized that didanosine has a low efficacy in the prevention and treatment of patients with the dementia complex of acquired immunodeficiency syndrome (AIDS) because “...the drug has not been detected in the cerebrospinal fluid”. We investigated didanosine concentrations in cerebrospinal fluid (CSF) and plasma of four patients with AIDS who were using didanosine chronically. Didanosine levels, 4 h after the last drug administration, averaged 0.16 (±0.03) μmol/l in CSF and 0.70 (±0.27) μmol/l in plasma. When compared with historical data from patients using zidovudine, didanosine concentrations in CSF appeared to be approximately half (on a molar base) those of zidovudine concentrations in the CSF. Whether this difference in CSF levels is the explanation for the presumed lower efficacy of didanosine in the prevention and treatment of AIDS dementia complex remains to be proven. However, it is clear from this study, in contrast with earlier suggestions, that didanosine is able to pass the blood-CSF barrier in human immunodeficiency virus-infected individuals.

Keywords

Acquired immunodeficiency syndrome AIDS dementia complex Blood-brain barrier Cerebrospinal fluid Didanosine Pharmacokinetics 

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Copyright information

© Royal Dutch Association for the Advancement of Pharmacy 1995

Authors and Affiliations

  • David M. Burger
    • 1
  • Cees L. Kraayeveld
    • 2
  • Pieter L. Meenhorst
    • 3
  • Jan W. Mulder
    • 3
  • Richard M. W. Hoetelmans
    • 1
  • Cees H. W. Koks
    • 1
  • Jos H. Beijnen
    • 1
  1. 1.Department of PharmacySlotervaart HospitalEC Amsterdamthe Netherlands
  2. 2.Department of NeurologySlotervaart HospitalAmsterdamthe Netherlands
  3. 3.Department of Internal MedicineSlotervaart HospitalAmsterdamthe Netherlands

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