Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Methotrexate
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methotrexate: moderate 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 disoproxil is renally eliminated and can cause tubular injury, and cobicistat raises serum creatinine by blocking tubular secretion. Methotrexate is also cleared by the kidney, so reduced renal function can delay its clearance and increase myelosuppression and mucositis. Emtricitabine is also renally cleared and can accumulate.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methotrexate 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 renal tubular toxicity and competition for renal elimination, leading to reduced methotrexate clearance.
What to do
Monitor serum creatinine, estimated GFR and complete blood count regularly, especially with higher methotrexate doses. Reduce or hold methotrexate if renal function declines.
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 Methotrexate
- Acitretin + Methotrexate Contraindicated
- Adenovirus types 4 and 7 live + Methotrexate Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Methotrexate Contraindicated
- Ketorolac + Methotrexate Contraindicated
- Measles mumps and rubella vaccine live + Methotrexate Contraindicated
- Measles mumps and rubella vaccine + Methotrexate Contraindicated
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Methotrexate?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methotrexate 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 disoproxil is renally eliminated and can cause tubular injury, and cobicistat raises serum creatinine by blocking tubular secretion. Methotrexate is also cleared by the kidney, so reduced renal function can delay its clearance and increase myelosuppression and mucositis. Emtricitabine is also renally cleared and can accumulate.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Methotrexate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine, estimated GFR and complete blood count regularly, especially with higher methotrexate doses. Reduce or hold methotrexate if renal function declines.
What other medicines interact with Methotrexate?
MediHelp also lists interactions of Methotrexate with, for example, Acitretin, Adenovirus types 4 and 7 live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Methotrexate page.
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