Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Ketorolac
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketorolac: 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 is renally eliminated and can be nephrotoxic, and ketorolac reduces renal blood flow and can itself injure the kidney. The combination increases the risk of acute kidney injury, and ketorolac is contraindicated in advanced renal impairment.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketorolac 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 with NSAID-induced reduction in renal perfusion and competition for renal elimination of tenofovir and emtricitabine.
What to do
Avoid ketorolac and use a non-NSAID analgesic; if an NSAID is unavoidable, monitor serum creatinine and renal function closely.
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 Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Ketorolac?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketorolac 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 is renally eliminated and can be nephrotoxic, and ketorolac reduces renal blood flow and can itself injure the kidney. The combination increases the risk of acute kidney injury, and ketorolac is contraindicated in advanced renal impairment.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Ketorolac?
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 ketorolac and use a non-NSAID analgesic; if an NSAID is unavoidable, monitor serum creatinine and renal function closely.
What other medicines interact with Ketorolac?
MediHelp also lists interactions of Ketorolac with, for example, Aceclofenac, Acemetacin, Acetylsalicylic acid. The full list is on the Ketorolac page.
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