Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Piroxicam
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Piroxicam: 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 is eliminated by the kidney, and NSAIDs can reduce renal blood flow and glomerular filtration. Concurrent use can raise tenofovir exposure and the risk of renal tubular toxicity and kidney injury. Cobicistat itself also raises serum creatinine by inhibiting tubular secretion.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Piroxicam 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
NSAID-induced reduction in renal perfusion and competition for tubular elimination add to the nephrotoxic potential of tenofovir.
What to do
Prefer a non-NSAID analgesic such as paracetamol. If an NSAID is necessary, use the lowest dose briefly and monitor serum creatinine, phosphate and urinalysis.
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 Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Piroxicam?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Piroxicam 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 blood flow and glomerular filtration. Concurrent use can raise tenofovir exposure and the risk of renal tubular toxicity and kidney injury. Cobicistat itself also raises serum creatinine by inhibiting tubular secretion.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Piroxicam?
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 a non-NSAID analgesic such as paracetamol. If an NSAID is necessary, use the lowest dose briefly and monitor serum creatinine, phosphate and urinalysis.
What other medicines interact with Piroxicam?
MediHelp also lists interactions of Piroxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Piroxicam page.
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