Mycophenolate mofetil may decrease the effectiveness of some oral contraceptives (birth control pills). Combining mycophenolate mofetil with birth control pills should be done cautiously, and additional contraceptive barriers (such as condoms) should be used.
Sevelamer (Renvela) may decrease MPA blood levels. Sevelamer and other calcium free phosphate binders that are used for treating patients with kidney disease should not be administered with mycophenolate mofetil. If combination treatment is necessary, sevelamer and other calcium free phosphate binders must be given two hours after mycophenolic acid administration.
Norfloxacin (Noroxin) and metronidazole (Flagyl), two antibiotics, may decrease MPA blood levels. Use of these antibiotics with mycophenolate mofetil is not recommended. Other antibiotics that may also decrease MPA levels in the blood are ciprofloxacin (Cipro), amoxicillin plus clavulanic acid (Augmentin), and rifampin (Rifadin, Rimactane).
Probenecid may cause an increase in MPA blood levels by inhibiting its excretion via renal tubular secretion.
PREGNANCY: Mycophenolate mofetil is classified as FDA pregnancy risk category D. Use of mycophenolate mofetil during pregnancy is associated with increased risk of first trimester pregnancy loss and congenital malformation and is not recommended during pregnancy.
NURSING MOTHERS: Mycophenolate mofetil is excreted in milk of rats. It is not known if it also is excreted in human milk. Due to the lack of conclusive safety data, mycophenolate mofetil should be used cautiously in nursing mothers.
REFERENCE: FDA Prescribing Information.
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