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Mycophenolate Mofetil Injection and Neoral

Determining the interaction of Mycophenolate Mofetil Injection and Neoral and the possibility of their joint administration.

Check result:

Mycophenolate Mofetil Injection <> Neoral

Relevance: 10.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

CycloSPORINE may decrease the blood levels and effects of mycophenolate mofetil. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration of cyclosporine with mycophenolate mofetil (MMF) may result in decreased concentrations of mycophenolic acid (MPA). The mechanism of the interaction is cyclosporine-mediated inhibition of multidrug-resistance protein 2 (MRP-2) transporter in the biliary tract which prevents the excretion of mycophenolic acid glucuronide (MPAG) into the bile which would lead to enterohepatic recirculation of MPA. MPA levels were reduced by 30% to 50% in renal transplant patients treated with MMF and cyclosporine compared with those who received sirolimus or belatacept and similar doses of MMF. In addition, MPA levels increased significantly after discontinuation of cyclosporine. MPA has been shown to have no effect on the pharmacokinetics of cyclosporine in stable renal transplant patients.

MANAGEMENT: Caution is advised when cyclosporine is used concomitantly with mycophenolate mofetil. Dosage adjustments as well as clinical and laboratory monitoring of MPA trough levels whenever cyclosporine is added to or discontinued from the patient's immunosuppressant regimen is recommended.

References

"Product Information. Myfortic (mycophenolic acid)." Novartis Pharmaceuticals, East Hanover, NJ.
Bornhauser M, Schuler U, Porksen G, Naumann R, Geissler G, Thiede C, Schwerdtfeger R, Ehninger G, Thiede HM "Mycophenolate mofetil and cyclosporine as graft-versus-host disease prophylaxis after allogeneic blood stem cell transplantation." Transplantation 67 (1999): 499-504
Lee PC, Chang SS, Shieh SC, et al. "Cyclosporine or Tacrolimus: Which Is the Better Partner for Myfortic or CellCept?" Transplant Proc 44 (2012): 137-9
Gregoor PJ, De Sevaux RG, Hene RJ, et al. "Effect of cyclosporine on mycophenolic acid trough levels in kidney transplant recipients." Transplantation 68 (1999): 1603-6
El-Sheikh AA, Koenderink JB, Wouterse AC, et al. "Renal glucuronidation and multidrug resistance protein 2-/ multidrug resistance protein 4-mediated efflux of mycophenolic acid: interaction with cyclosporine and tacrolimus." Transl Res 164 (2014): 46-56

Mycophenolate Mofetil Injection

Generic Name: mycophenolate mofetil

Brand name: Cellcept, Myfortic, MMF

Synonyms: Mycophenolate, Mycophenolate mofetil (oral/injection)

What is Mycophenolate Mofetil Injection?

Neoral

Generic Name: cyclosporine

Brand name: Gengraf, Neoral, Sandimmune, Sandimmune

Synonyms: Neoral (Capsules, Modified)

What is Neoral?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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