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Drug Interactions between diclofenac and elvitegravir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

diclofenac elvitegravir

Applies to: diclofenac and elvitegravir

MONITOR: Coadministration with CYP450 2C9 inducers, such as rifampin, may decrease the plasma concentrations and therapeutic effects of diclofenac. The proposed mechanism is rifampin-mediated induction of CYP450 2C9, the isoenzyme responsible for the metabolic clearance of diclofenac. In a study involving 6 healthy subjects, after receiving rifampin 450 mg daily for 6 days, the Cmax and AUC of a single 100 mg dose of diclofenac was reduced by 43% and 67%, respectively.

MANAGEMENT: The potential for diminished pharmacologic effects of diclofenac should be considered during coadministration with CYP450 2C9 inducers, such as rifampin. Pharmacologic response to diclofenac should be monitored and the diclofenac dosage adjusted as necessary whenever a CYP450 2C9 inducer is added to or withdrawn from therapy.

References (3)
  1. (2001) "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals
  2. Cerner Multum, Inc. "Australian Product Information."
  3. Kumar JS, Rao Mamidi NVS, Chakrapani T (1995) "Rifampicin pretreatment reduces bioavailability of diclofenac sodium." Indian J Pharmacol, 27, p. 183-5

Drug and food interactions

Moderate

elvitegravir food

Applies to: elvitegravir

ADJUST DOSING INTERVAL: Food enhances the oral bioavailabilities of both elvitegravir and tenofovir. When a single dose of cobicistat/elvitegravir/emtricitabine/tenofovir (trade name Stribild) was given with a light meal (approximately 373 kcal; 20% fat), mean elvitegravir and tenofovir systemic exposures (AUCs) increased by 34% and 24%, respectively, relative to fasting conditions. When administered with a high-fat meal (approximately 800 kcal; 50% fat), the mean AUC of elvitegravir and tenofovir increased by 87% and 23%, respectively, relative to fasting conditions. The alterations in mean AUCs of cobicistat and emtricitabine were not clinically significant with either the light or high-fat meal.

MANAGEMENT: Cobicistat/elvitegravir/emtricitabine/tenofovir as a fixed-dose preparation should be administered once daily with food. Elvitegravir as a single-ingredient preparation should also be administered once daily with food.

References (2)
  1. (2012) "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences
  2. (2014) "Product Information. Vitekta (elvitegravir)." Gilead Sciences
Moderate

diclofenac food

Applies to: diclofenac

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References (1)
  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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