Interaction Checker
Potential Interaction
Tenofovir-DF (TDF)
Vancomycin
Quality of Evidence: Moderate
Summary:
Coadministration has not been studied. Vancomycin is eliminated unchanged predominantly via glomerular filtration, and there is little potential for interaction with tenofovir-DF via competition for active renal transport mechanisms. However, both vancomycin and tenofovir-DF are potentially nephrotoxic and tenofovir-DF should be avoided with concurrent or recent use of a nephrotoxic agent. If concomitant use of tenofovir-DF and nephrotoxic agents is unavoidable, renal function should be monitored closely. A case study described renal failure in 2 patients taking tenofovir-DF and a prolonged course of vancomycin.
Description:
Tenofovir disoproxil fumarate has not been evaluated in patients receiving nephrotoxic medicinal products (e.g. aminoglycosides, amphotericin B, foscarnet, ganciclovir, pentamidine, vancomycin, cidofovir or interleukin-2). Use of tenofovir disoproxil fumarate should be avoided with concurrent or recent use of a nephrotoxic medicinal product. If concomitant use of tenofovir disoproxil fumarate and nephrotoxic agents is unavoidable, renal function should be monitored weekly.
Viread Summary of Product Characteristics, Gilead Sciences Ltd, September 2016.
Tenofovir-DF should be avoided with concurrent or recent use of a nephrotoxic agent. Since tenofovir-DF is primarily eliminated by the kidneys, coadministration of tenofovir-DF with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of tenofovir and/or increase the concentrations of other renally eliminated drugs. Some examples include, but are not limited to, cidofovir, acyclovir, valacyclovir, ganciclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs.
Viread Prescribing Information, Gilead Sciences International Inc, February 2016.
Renal failure developed after a prolonged course of vancomycin therapy in 2 patients who were receiving tenofovir disoproxil fumarate as part of an antiretroviral regimen. Tenofovir has been implicated in the development of Fanconi syndrome and renal insufficiency because of its effects on the proximal renal tubule. Vancomycin nephrotoxicity is infrequent but may result from coadministration with a nephrotoxic agent. Coadministration may raise the risk of renal failure during prolonged administration of vancomycin.
Acute renal failure in patients with AIDS on tenofovir while receiving prolonged vancomycin course for osteomyelitis. Psevdos G Jr, Gonzalez E, Sharp V. AIDS Read. 2009 Jun-Jul;19(6):245-8.
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