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Mycophenolate and Multivitamins with minerals

Result of checking the interaction of Mycophenolate and Multivitamins with minerals for safety when used together.

Check result:
Mycophenolate <> Multivitamins with minerals
Relevance: 03.07.2019 Reviewer: Shkutko P.M., M.D., in

When checking interaction based on authoritative sources Drugs.com, Rxlist.com, Webmd.com, Medscape.com there are contraindications or side effects that may cause harm or increase the negative effect from drug interaction with food or lifestyle.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Limited data suggest that the oral bioavailability of mycophenolic acid (MPA) may be decreased by concomitant administration of iron preparations. The mechanism of interaction has not been established, and available data are conflicting. In an early study with seven healthy subjects, administration of 1 gram of mycophenolate mofetil (MMF) with a single 1050 mg dose of sustained-release ferrous sulfate (equivalent to 210 mg of elemental iron) decreased mean MPA peak plasma concentration (Cmax) and systemic exposure (AUC) by 94% and 91%, respectively, compared to administration of MMF alone. However, several subsequent studies, including some conducted in kidney transplant patients, reported no significant changes in MPA pharmacokinetics during coadministration with iron at the same time or up to four hours apart. The reasons for the discrepancy have not been determined. In vitro, there was no evidence of complexation between iron and MMF or MPA. No precautions appear necessary to avoid potential interaction; however, it may be advisable to monitor pharmacologic response and blood levels closely if an iron product is added to stabilized mycophenolate therapy.

References:
  • Gelone DK, Park JM, Lake KD "Lack of an effect of oral iron administration on mycophenolic acid pharmacokinetics in stable renal transplant recipients." Pharmacotherapy 27 (2007): 1272-8
  • Morii M, Ueno K, Ogawa A, Kato R, Yoshimura H, Wada K, Hashimoto H, Takada M, Tanaka K, Nakatani T, Shibakawa M "Impairment of mycophenolate mofetil absorption by iron ion." Clin Pharmacol Ther 68 (2000): 613-6
  • Lorenz M, Wolzt M, Weigel G, et al. "Ferrous sulfate does not affect mycophenolic acid pharmacokinetics in kidney transplant patients." Am J Kidney Dis 43 (2004): 1098-103
  • Mudge DW, Atcheson B, Taylor PJ, et al. "The effect of oral iron administration on mycophenolate mofetil absorption in renal transplant recipients: a randomized, controlled trial." Transplantation 77 (2004): 206-9
  • "Product Information. CellCept (mycophenolate mofetil)." Roche Laboratories, Nutley, NJ.
  • Ducray PS, Banken L, Gerber M, Boutouyrie B, Zandt H "Absence of an interaction between iron and mycophenolate mofetil absorption." Br J Clin Pharmacol 62 (2006): 492-5
  • Lidgate D, Brandl M, Holper M, Abubakari A, Wu X "Influence of ferrous sulfate on the solubility, partition coefficient, and stability of mycophenolic acid and the ester mycophenolate mofetil." Drug Dev Ind Pharm 28 (2002): 1275-83
  • "Product Information. Myfortic (mycophenolic acid)." Novartis Pharmaceuticals, East Hanover, NJ.
Mycophenolate

Generic Name: mycophenolate mofetil

Brand Name: Cellcept, Myfortic, MMF

Synonyms: Mycophenolate mofetil (oral/injection)

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