Drug interactions
Diclofenac + Tenofovir df
Severity: Major
Diclofenac and 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
NSAIDs reduce renal perfusion through prostaglandin inhibition, and tenofovir is nephrotoxic to proximal tubules and eliminated renally. Combined use, especially at high or repeated NSAID doses, has been associated with acute kidney injury and may raise tenofovir exposure.
What this interaction means in plain words
Diclofenac and 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 nephrotoxicity: NSAID-induced renal hypoperfusion plus tenofovir tubular toxicity, with possible reduced tenofovir clearance.
What to do
Prefer non-NSAID analgesics such as paracetamol in patients on tenofovir DF. If an NSAID is unavoidable, use the lowest dose briefly and monitor serum creatinine 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 Tenofovir df?
MediHelp rates the interaction as major. Diclofenac and 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. NSAIDs reduce renal perfusion through prostaglandin inhibition, and tenofovir is nephrotoxic to proximal tubules and eliminated renally. Combined use, especially at high or repeated NSAID doses, has been associated with acute kidney injury and may raise tenofovir exposure.
How serious is the interaction between Diclofenac and 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: Prefer non-NSAID analgesics such as paracetamol in patients on tenofovir DF. If an NSAID is unavoidable, use the lowest dose briefly and monitor serum creatinine 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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