Drug interactions
Elvitegravir / cobicistat / emtricitabine / tenofovir df + Tobramycin
Severity: Major
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Tobramycin: 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 disoproxil can injure the proximal tubule, and tobramycin is nephrotoxic, so together they raise the risk of acute kidney injury. Cobicistat also raises serum creatinine by blocking tubular secretion, which can make real changes in renal function harder to interpret.
What this interaction means in plain words
Elvitegravir / cobicistat / emtricitabine / tenofovir df and Tobramycin 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 affecting the renal proximal tubule.
What to do
Avoid concurrent use when possible. If tobramycin is required, monitor creatinine, estimated clearance, urine protein and glucose, and tobramycin levels.
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 Tobramycin
- Cidofovir + Tobramycin Contraindicated
- Adefovir + Tobramycin Major
- Amikacin + Tobramycin Major
- Amphotericin b deoxycholate + Tobramycin Major
- Amphotericin b + Tobramycin Major
- Atracurium + Tobramycin Major
Frequently asked questions
Can I take Elvitegravir / cobicistat / emtricitabine / tenofovir df with Tobramycin?
MediHelp rates the interaction as major. Elvitegravir / cobicistat / emtricitabine / tenofovir df and Tobramycin 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 disoproxil can injure the proximal tubule, and tobramycin is nephrotoxic, so together they raise the risk of acute kidney injury. Cobicistat also raises serum creatinine by blocking tubular secretion, which can make real changes in renal function harder to interpret.
How serious is the interaction between Elvitegravir / cobicistat / emtricitabine / tenofovir df and Tobramycin?
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 concurrent use when possible. If tobramycin is required, monitor creatinine, estimated clearance, urine protein and glucose, and tobramycin levels.
What other medicines interact with Tobramycin?
MediHelp also lists interactions of Tobramycin with, for example, Cidofovir, Adefovir, Amikacin. The full list is on the Tobramycin page.
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