{"id":51017,"date":"2023-09-20T09:16:16","date_gmt":"2023-09-20T09:16:16","guid":{"rendered":"https:\/\/medsname.com\/dinex-ec\/"},"modified":"2026-04-30T16:19:02","modified_gmt":"2026-04-30T16:19:02","slug":"dinex-ec","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/dinex-ec\/","title":{"rendered":"Dinex Ec"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Dinex EC<\/strong> \u2014 didanosin 250\/400 mg v enterosolventn\u00edch kapsl\u00edch (Cipla). NRTI pro HIV \u2014 star\u0161\u00ed l\u00e9\u010divo, nyn\u00ed vyhrazen\u00e9 pro z\u00e1chrannou terapii nebo prost\u0159ed\u00ed, kde nejsou dostupn\u00e9 modern\u00ed NRTI. Mitochondri\u00e1ln\u00ed toxicita (perifern\u00ed neuropatie, pankreatitida, lakt\u00e1tov\u00e1 acid\u00f3za) omezuje pou\u017eit\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Dinex EC je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturace prob\u00edh\u00e1 p\u0159es regulovan\u00e9ho platebn\u00edho procesora (na v\u00fdpisu z karty se zobraz\u00ed regulovan\u00fd platebn\u00ed procesor \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed 20pracovnodenn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>FDA \u010dern\u00fd r\u00e1me\u010dek: pankreatitida + lakt\u00e1tov\u00e1 acid\u00f3za<\/strong><br \/>Didanosin nese n\u011bkolik \u010dern\u00fdch v\u00fdstrah: fat\u00e1ln\u00ed lakt\u00e1tov\u00e1 acid\u00f3za s jatern\u00ed steat\u00f3zou (zejm\u00e9na se stavudinem nebo v t\u011bhotenstv\u00ed), t\u011b\u017ek\u00e1 pankreatitida (v\u00fdskyt 5-7 % \u2013 hl\u00e1\u0161eny fat\u00e1ln\u00ed p\u0159\u00edpady), perifern\u00ed neuropatie (12-34 %), zm\u011bny na s\u00edtnici\/optick\u00e1 neuritida. Modern\u00ed l\u00e9\u010dba HIV didanosin ji\u017e v\u011bt\u0161inou nepou\u017e\u00edv\u00e1.<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Pro\u010d se didanosin st\u00e1le pou\u017e\u00edv\u00e1?<\/h3>\n<p>V prost\u0159ed\u00edch s omezen\u00fdmi zdroji, z\u00e1chrann\u00e9 re\u017eimy po mnohon\u00e1sobn\u00e9 rezistenci HIV nebo specifick\u00e9 historick\u00e9 situace. Modern\u00ed doporu\u010den\u00ed pou\u017e\u00edvaj\u00ed TDF nebo TAF (nebo abakavir) + lamivudin\/emtricitabin m\u00edsto toho \u2013 mnohem lep\u0161\u00ed bezpe\u010dnostn\u00ed profil.<\/p>\n<h3>Varov\u00e1n\u00ed p\u0159ed pankreatitidou?<\/h3>\n<p>5-7 % pacient\u016f rozvine pankreatitidu. Okam\u017eit\u011b p\u0159eru\u0161te l\u00e9\u010dbu p\u0159i bolesti b\u0159icha a zv\u00fd\u0161en\u00e9 amyl\u00e1ze\/lip\u00e1ze. Vyhn\u011bte se kombinaci s dal\u0161\u00edmi l\u00e9ky zvy\u0161uj\u00edc\u00edmi riziko pankreatitidy (alkohol, valpro\u00e1t, hypertriglyceridemie).<\/p>\n<h3>Perifern\u00ed neuropatie?<\/h3>\n<p>\u010cast\u00e1 (12-34 %) a z\u00e1visl\u00e1 na d\u00e1vce. Obvykle reverzibiln\u00ed, pokud je l\u00e9k v\u010das vysazen. Kombinace se stavudinem riziko zvy\u0161uje \u2013 nikdy nekombinujte d4T + ddI.<\/p>\n<h3>Lakt\u00e1tov\u00e1 acid\u00f3za?<\/h3>\n<p>Projev mitochondri\u00e1ln\u00ed toxicity. \u010cast\u011bj\u0161\u00ed p\u0159i kombinaci d4T+ddI, u \u017een, v t\u011bhotenstv\u00ed, u obezity. P\u0159\u00edznaky: mal\u00e1tnost, \u00fanava, bolesti b\u0159icha, du\u0161nost, nevolnost. L\u00e9k okam\u017eit\u011b vysa\u010fte.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>Tenofovir + didanosin zvy\u0161uje hladiny ddI \u2013 vyhn\u011bte se kombinaci nebo sni\u017ete d\u00e1vku ddI. Allopurinol zvy\u0161uje hladiny ddI (vyvarujte se). Metadon sni\u017euje hladiny ddI (klinicky nev\u00fdznamn\u00e9).<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Vyhn\u011bte se u\u017e\u00edv\u00e1n\u00ed v t\u011bhotenstv\u00ed kv\u016fli riziku lakt\u00e1tov\u00e9 acid\u00f3zy (zejm\u00e9na s d4T).<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>U\u017eijte, kdy\u017e si vzpomenete, pokud je tent\u00fd\u017e den; jinak vynechejte. Neduplikujte d\u00e1vky. Dodr\u017eov\u00e1n\u00ed re\u017eimu je kl\u00ed\u010dov\u00e9 \u2013 a tento l\u00e9k je obt\u00ed\u017en\u00e9 u\u017e\u00edvat pravideln\u011b kv\u016fli dietn\u00edm omezen\u00edm a vedlej\u0161\u00edm \u00fa\u010dink\u016fm.<\/p>\n<h3>Nala\u010dno?<\/h3>\n<p>Star\u0161\u00ed formulace vy\u017eadovaly u\u017e\u00edv\u00e1n\u00ed nala\u010dno; enterosolventn\u00ed formulace se u\u017e\u00edv\u00e1 nala\u010dno (1 hodinu p\u0159ed nebo 2 hodiny po j\u00eddle) \u2013 j\u00eddlo sni\u017euje absorpci p\u0159ibli\u017en\u011b o 50 %.<\/p>\n<h3>Kdy by m\u011bl b\u00fdt vysazen?<\/h3>\n<p>T\u011b\u017ek\u00e1 pankreatitida (jak\u00e1koli), progrese perifern\u00ed neuropatie, lakt\u00e1tov\u00e1 acid\u00f3za, zm\u011bny na s\u00edtnici nebo virologick\u00e9 selh\u00e1n\u00ed vy\u017eaduj\u00ed vysazen\u00ed nebo substituci l\u00e9\u010dby. V\u011bt\u0161ina pacient\u016f u\u017e\u00edvaj\u00edc\u00edch ddI v modern\u00ed p\u00e9\u010di by m\u011bla b\u00fdt konzultov\u00e1na s HIV specialistou ohledn\u011b p\u0159echodu na bezpe\u010dn\u011bj\u0161\u00ed alternativy.<\/p>\n<h3>Dlouhodob\u00e1 progn\u00f3za?<\/h3>\n<p>T\u00e9m\u011b\u0159 v\u0161ichni pacienti s HIV v modern\u00ed p\u00e9\u010di by m\u011bli b\u00fdt na re\u017eimu zalo\u017een\u00e9m na TDF, TAF nebo abakaviru s INSTI jako t\u0159et\u00ed l\u00e1tkou. Pokra\u010duj\u00edc\u00ed u\u017e\u00edv\u00e1n\u00ed ddI by m\u011blo b\u00fdt p\u0159ezkoum\u00e1v\u00e1no p\u0159i ka\u017ed\u00e9 n\u00e1v\u0161t\u011bv\u011b kliniky s jasn\u00fdm pl\u00e1nem p\u0159echodu, jakmile budou k dispozici bezpe\u010dn\u011bj\u0161\u00ed alternativy.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed l\u00e9ky na HIV a antivirotika<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/trioday\/\">Trioday<\/a> \u2014 TDF + 3TC + EFV \u2014 jednoduch\u00fd re\u017eim v jedn\u00e9 tablet\u011b od Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/triomune\/\">Triomune<\/a> \u2014 d4T + 3TC + NVP \u2014 star\u0161\u00ed 3v1 kombinace (na b\u00e1zi stavudinu)<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zepdon\/\">Zepdon<\/a> \u2014 raltegravir 400 mg \u2014 inhibitor integr\u00e1zy<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/abamune-l\/\">Abamune L<\/a> \u2014 abakavir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenvir-l\/\">Tenvir L<\/a> \u2014 tenofovir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> L\u00e9\u010dba HIV je komplexn\u00ed, celo\u017eivotn\u00ed terapie. V\u00fdb\u011br l\u00e9k\u016f z\u00e1vis\u00ed na genotypu, testech rezistence, p\u0159idru\u017een\u00fdch onemocn\u011bn\u00edch a p\u0159edchoz\u00ed l\u00e9\u010db\u011b. Jakoukoli zm\u011bnu re\u017eimu konzultujte s odborn\u00edkem na HIV. Pro prevenci rezistence je nutn\u00e1 adherence &gt;95%. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby obsahuj\u00edc\u00ed tenofovir, lamivudin nebo emtricitabin testujte HBV \u2014 vysazen\u00ed m\u016f\u017ee u pacient\u016f s koinfekc\u00ed zp\u016fsobit z\u00e1va\u017en\u00e9 vzplanut\u00ed HBV.<\/div>","protected":false},"excerpt":{"rendered":"<p>Dinex EC (Didanosin 250\/400 mg) \u2014 star\u0161\u00ed NRTI od Cipla pro HIV. Vyhrazeno pro z\u00e1chrannou terapii. FDA varov\u00e1n\u00ed v \u010dern\u00e9m r\u00e1me\u010dku: pankreatitida, lakt\u00e1tov\u00e1 acid\u00f3za a perifern\u00ed neuropatie.<\/p>","protected":false},"featured_media":51018,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3304],"product_tag":[3318],"class_list":{"0":"post-51017","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hiv-medication","9":"product_tag-didanosine","11":"first","12":"outofstock","13":"shipping-taxable","14":"purchasable","15":"product-type-variable","16":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51017","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51017"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51018"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51017"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51017"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51017"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51017"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}