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Drug Interactions between CellCept and Nexium

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

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Interactions between your drugs

Moderate

mycophenolate mofetil esomeprazole

Applies to: CellCept (mycophenolate mofetil) and Nexium (esomeprazole)

MONITOR: Coadministration with inhibitors of the proton pump (PPIs or potassium-competitive acid blockers [PCABs]) may reduce the bioavailability of mycophenolic acid (MPA) from the administration of mycophenolate mofetil. The exact mechanism of interaction has not been established, but may involve a decrease in MPA solubility at higher gastric pH levels. When single doses of proton pump inhibitors were given to healthy volunteers and multiple doses to transplant patients receiving mycophenolate mofetil, MPA peak plasma concentration (Cmax) was reduced by 30% to 70% and systemic exposure (AUC) by 25% to 35%. The clinical significance is unknown. The interaction does not appear to occur when mycophenolic acid itself is administered. In 12 healthy volunteers, the pharmacokinetics of MPA were observed to be similar when a single 720 mg dose of mycophenolic acid was administered alone and following concomitant administration with pantoprazole, which was administered at a dosage of 40 mg twice daily for 4 days.

MANAGEMENT: Because clinical relevance of this interaction has not been established, PPIs or PCABs should be used with caution in transplant patients receiving mycophenolate mofetil.

References

  1. "Product Information. CellCept (mycophenolate mofetil)." Roche Laboratories PROD (2001):
  2. "Product Information. Myfortic (mycophenolic acid)." Novartis Pharmaceuticals (2004):
  3. "Product Information. Voquezna Dual Pak (amoxicillin-vonoprazan)." Phathom Pharmaceuticals, Inc ORIG-1 (2022):
  4. "Product Information. Voquezna Triple Pak (amoxicillin/clarithromycin/vonoprazan)." Phathom Pharmaceuticals, Inc ORIG-1 (2022):
View all 4 references

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Drug and food interactions

Moderate

esomeprazole food

Applies to: Nexium (esomeprazole)

ADJUST DOSING INTERVAL: Food may interfere with the absorption of esomeprazole. The manufacturer reports that the area under the concentration-time curve for esomeprazole following a single 40 mg dose was 33% to 53% lower when administered after food intake as opposed to during fasting conditions.

MANAGEMENT: Esomeprazole should be taken at least one hour before meals. When administered to patients receiving continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of esomeprazole is given.

References

  1. "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals PROD (2001):
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67

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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.

See also

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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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