Drug interactions
Diclofenac + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Major
Diclofenac and Elvitegravir / cobicistat / emtricitabine / tenofovir df: major interaction.
Last updated
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
Tenofovir and emtricitabine are eliminated by the kidney, and cobicistat raises serum creatinine by inhibiting tubular secretion. Adding an NSAID such as diclofenac may increase the risk of nephrotoxicity, particularly with high or repeated doses or existing renal impairment.
What this interaction means in plain words
Diclofenac and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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 renal toxicity from NSAID reduction of renal prostaglandin-mediated perfusion and competition for renal elimination with tenofovir.
What to do
Avoid chronic or high-dose NSAIDs where possible and use alternative analgesia such as paracetamol. If an NSAID is needed, monitor serum creatinine, estimated GFR and phosphate.
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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Other interactions of Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Frequently asked questions
Can I take Diclofenac with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as major. Diclofenac and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Tenofovir and emtricitabine are eliminated by the kidney, and cobicistat raises serum creatinine by inhibiting tubular secretion. Adding an NSAID such as diclofenac may increase the risk of nephrotoxicity, particularly with high or repeated doses or existing renal impairment.
How serious is the interaction between Diclofenac and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid chronic or high-dose NSAIDs where possible and use alternative analgesia such as paracetamol. If an NSAID is needed, monitor serum creatinine, estimated GFR and phosphate.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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