Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sulindac
Severity: Moderate
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Sulindac: 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 and emtricitabine are eliminated by the kidney, and NSAIDs can reduce renal perfusion and cause kidney injury. Together they may raise tenofovir exposure and increase the risk of tenofovir-related nephrotoxicity, particularly with high-dose or prolonged NSAID use, and cobicistat may also raise serum creatinine.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Sulindac 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 prostaglandin-dependent perfusion and possible competition for renal tubular secretion add to tenofovir nephrotoxicity.
What to do
Prefer a non-NSAID analgesic such as paracetamol where possible. If sulindac is needed, use the lowest dose for the shortest time and monitor serum creatinine and eGFR.
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 Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Sulindac?
MediHelp rates the interaction as moderate. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Sulindac 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 and emtricitabine are eliminated by the kidney, and NSAIDs can reduce renal perfusion and cause kidney injury. Together they may raise tenofovir exposure and increase the risk of tenofovir-related nephrotoxicity, particularly with high-dose or prolonged NSAID use, and cobicistat may also raise serum creatinine.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Sulindac?
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 where possible. If sulindac is needed, use the lowest dose for the shortest time and monitor serum creatinine and eGFR.
What other medicines interact with Sulindac?
MediHelp also lists interactions of Sulindac with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Sulindac page.
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