Drug interactions
Colistin + Tenofovir disoproxil
Severity: Major
Colistin and Tenofovir disoproxil: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Colistin is a well-known cause of acute kidney injury, and tenofovir can contribute to tubular toxicity. Concurrent use may increase the risk of renal impairment, and declining renal function raises tenofovir exposure.
What this interaction means in plain words
Colistin and Tenofovir disoproxil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive nephrotoxicity affecting renal tubules, with reduced tenofovir clearance as function declines.
What to do
Monitor creatinine, urine output and electrolytes frequently and consider temporarily replacing tenofovir disoproxil with a non-nephrotoxic alternative. Adjust the tenofovir interval to creatinine clearance.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Colistin
- Colistin + Polymyxin b Contraindicated
- Amikacin + Colistin Major
- Amphotericin b deoxycholate + Colistin Major
- Amphotericin b + Colistin Major
- Atracurium + Colistin Major
- Bacitracin + Colistin Major
Frequently asked questions
Can I take Colistin with Tenofovir disoproxil?
MediHelp rates the interaction as major. Colistin and Tenofovir disoproxil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Colistin is a well-known cause of acute kidney injury, and tenofovir can contribute to tubular toxicity. Concurrent use may increase the risk of renal impairment, and declining renal function raises tenofovir exposure.
How serious is the interaction between Colistin and Tenofovir disoproxil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor creatinine, urine output and electrolytes frequently and consider temporarily replacing tenofovir disoproxil with a non-nephrotoxic alternative. Adjust the tenofovir interval to creatinine clearance.
What other medicines interact with Colistin?
MediHelp also lists interactions of Colistin with, for example, Polymyxin b, Amikacin, Amphotericin b deoxycholate. The full list is on the Colistin page.
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