Drug interactions
Diflunisal + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Diflunisal and Elvitegravir / cobicistat / emtricitabine / tenofovir df: moderate interaction.
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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 is eliminated by the kidney, and NSAIDs can reduce renal perfusion, which raises the risk of tenofovir-associated kidney injury. Cobicistat also raises serum creatinine by inhibiting tubular secretion, which can complicate assessment of renal function.
What this interaction means in plain words
Diflunisal and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive nephrotoxic potential with NSAID-induced reduction in renal blood flow and competition for renal elimination of tenofovir.
What to do
Prefer non-NSAID analgesics such as paracetamol where possible. If an NSAID is needed, use the lowest dose for the shortest time and monitor creatinine and renal function.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Frequently asked questions
Can I take Diflunisal with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Diflunisal and Elvitegravir / cobicistat / emtricitabine / tenofovir df can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tenofovir is eliminated by the kidney, and NSAIDs can reduce renal perfusion, which raises the risk of tenofovir-associated kidney injury. Cobicistat also raises serum creatinine by inhibiting tubular secretion, which can complicate assessment of renal function.
How serious is the interaction between Diflunisal and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates it moderate, 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 where possible. If an NSAID is needed, use the lowest dose for the shortest time and monitor creatinine and renal function.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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